Oral Answers to Questions

HEALTH

The Secretary of State was asked—

Waiting Times

Andrew Robathan: How many people in Leicestershire waited for more than six months from GP referral to operating theatre for elective operations in the last period for which figures are available.

Patricia Hewitt: At the end of November 2006, seven Leicester patients had been waiting for more than six months for in-patient treatment following the decision to admit. That compares with 3,437 in March 1997.

Andrew Robathan: It is interesting to note that on 16 November, the Secretary of State said:
	"We have cut the waiting time for elective operations, hip replacements and so on... from GP referral to the operating theatre".—[ Official Report, 16 November 2006; Vol. 666, c. 147.]
	Will she look into the case of Mr. Ferriman, who lives in Braunstone town, about 100 yards from her constituency? His GP referred him for a hip replacement in April last year, and he has been given an appointment for an operation in April this year. Does the Secretary of State think that that counts as less than six months?

Patricia Hewitt: If the hon. Gentleman sends me the details, I will of course examine the case and write to him, but I am surprised and disappointed that he did not take the opportunity to congratulate the NHS on bringing waiting times down to their lowest level since records began. I am really not prepared to take lectures on waiting times from the hon. Gentleman, who voted against the increased investment that we are making in the NHS.

Andy Reed: I welcome the reductions in waiting times, and if there are cases in which individuals have struggled I am sure that my right hon. Friend will look into them; but will she also acknowledge that one of the consequences of increased throughput is the potential for superbugs? Is she aware of the campaign launched by the  Loughborough Echo, aimed particularly at clostridium difficile and its consequences for my constituents? Will she try to ensure that it appears on death certificates in future, to make not just patients but hospital staff more aware of the problem?

Patricia Hewitt: We all share my hon. Friend's concern about the increase in clostridium difficile—which is a particularly problematic hospital-acquired infection—in some hospitals, including hospitals in Leicester. That makes it all the more important for us not just to continue to shorten waiting times for operations but to ensure that patients are treated in the community, closer to their homes, when that is appropriate and clinically safe.

Stephen Dorrell: I join the Secretary of State in welcoming the reduction in six-month waiting times in Leicestershire, but may I remind her of information given by the Minister of State, Department of Health, the hon. Member for Leigh (Andy Burnham), in a written answer on 8 November 2006? He reported that in the NHS as a whole, 87 per cent. of patients had been treated within six months in the year to last April. May I also remind the Secretary of State that in 1990, 17 years ago, the equivalent figure was 86 per cent.? Does she think that an increase of one percentage point over 17 years is a good return for the huge increase in investment that she mentioned earlier?

Patricia Hewitt: I am glad that the right hon. Gentleman began by congratulating the NHS, and I welcome his recognition that waiting times for elderly people needing hip replacements, for instance, were longer than 18 months when he was Secretary of State for Health. But of course we need to do more, which is exactly why we have promised that by the end of 2008 the maximum wait from GP referral to operating theatre will be just 18 weeks, but that for most people the wait will be much shorter. I hope that the Conservative party will support the NHS in making the further changes needed to achieve that dramatic improvement in care, and will congratulate the NHS as it achieves them.

Keith Vaz: I thank my right hon. Friend for increasing the budget of the primary care trust over the past 10 years. It doubled to £173 million last year. Does she, however, share my concern and that of my constituents, who, when they try to obtain appointments with GPs for referral purposes, are met with administrative delays and difficulties? Is she planning any guidance for local GPs on the way in which their front-line staff should deal with the public, so that when people ring to ask for an appointment they are given one and are therefore referred as quickly as possible?

Patricia Hewitt: My right hon. Friend is right. Because some general practices—although, I think, only a minority—do not have proper appointment systems, it can be very difficult for people to obtain appointments when they need them, whether on the same day or in advance if that is what they require. However, I hope that my right hon. Friend welcomes the fact that thanks to the target we have set, people no longer wait for weeks on end to obtain appointments. I believe that the patient survey which will begin this month, and which will be linked to GPs' pay, will ensure that the minority of GPs who are not yet offering convenient appointments will do so in future.

Mental Health

Kerry McCarthy: What assessment she has made of the effect of the introduction of supervised community treatment on the care of patients with mental health problems.

Rosie Winterton: We are introducing supervised community treatment for patients who have been detained in hospital under the Mental Health Act 1983. That is an important change, which brings legislation into line with modern service delivery and follows the example of modern practice in other countries around the world.

Kerry McCarthy: I am sure my right hon. Friend is aware of the fear expressed by some in the mental health world that people could continue to be given supervised community treatment for lengthy periods without the introduction of adequate safeguards. Can she assure me that that will not happen?

Rosie Winterton: My hon. Friend is right that such concerns have been expressed, but I hope that I can reassure her that patients receiving supervised community treatment will be entitled to a comprehensive package of safeguards that are just the same as those for patients detained in hospital. The need for SCT will be subject to regular review in exactly the same way, and patients will have the right to apply for discharge to a tribunal and the hospital managers of their responsible hospital.

Sandra Gidley: The Minister mentioned countries around the world, so presumably the Department of Health has access to information that proves that supervised community treatments are successful around the world. When will that information be released for general consumption?

Rosie Winterton: A number of studies have been carried out into SCT. As I have said, it is available in countries around the world—including Scotland, now—to bring them in line with modern service provision. One of the published studies is from New Zealand; it shows that SCT not only worked for carers and patients' families, but that patients also liked it because it meant that they could return home instead of having to be detained in hospital. The Department is also carrying out some research; it is currently being peer-reviewed, and it will be published fairly shortly.

Meg Hillier: Hackney, South and Shoreditch has a higher than average incidence of mental health issues, and I have received a lot of correspondence from people about community treatment orders; psychiatrists have raised the issue of holding people against their will in the community. Although I think that community treatment can be better than hospital treatment, how can my right hon. Friend reassure those with concerns that people will not be held against their will but will receive the treatment that they need and that their lives and their community will be made better?

Rosie Winterton: First, it is important to emphasise that clinicians will decide whether supervised community treatment is appropriate for individual patients. We all know that there are instances of patients being released from hospital who then go into the community and who, perhaps, do not take their medication or stay in touch with health services, and whose condition deteriorates to such an extent that they become a danger to themselves or to other people. That is an example of where SCT could apply. It is important to remember that that often puts patients back into the care of their families, instead of their having to remain in hospital. That will be good for patients and for public safety.

Tim Loughton: The Minister acknowledges that community treatment orders are a contentious provision in the Mental Health Bill, so will she now confirm that her Department commissioned a report entitled "International experiences of using community treatment orders", which was delivered to her last autumn, and which concluded, from a survey of 50 countries, that CTOs have been found to have no clear effect on patient outcomes or risk reduction, and that these psychiatric ASBOs have been described as discriminatory by many patient groups, not least those representing BME—black and minority ethnic—patients who have suffered disproportionately? Why has she failed to publish this report, after my parliamentary questions and my freedom of information request, given its relevance to the Mental Health Bill which is currently under scrutiny in Parliament?

Rosie Winterton: As I have said, the report is being peer-reviewed, and it will be published. Frankly, the Opposition must decide whether they will support a Bill that will introduce supervised community treatment so that high-risk patients get the treatment that they need to keep them well after they are discharged from hospital, and that will lead to people who have potentially serious and dangerous personality disorders getting the treatment that they need. That is the issue.
	The hon. Gentleman has called these measures the Government's latest attack on civil liberties. He needs to think very carefully about the civil liberties of people who go in and out of hospital three or four times a year because we cannot get treatment to them, and the civil liberties of patients, victims and their families who have suffered because we do not have the powers to treat people in the community.

Health Inequalities

Linda Gilroy: If she will make a statement on the steps she is taking to address health inequalities in Plymouth.

Caroline Flint: Recent figures show that Plymouth is reducing inequalities in coronary heart disease and cancer, although there is more to do on life expectancy and infant mortality. There is active co-operation between the primary care trust, the local authority and other partners to tackle health inequalities in Plymouth.

Linda Gilroy: I thank the Minister for her recognition of the good work done by people in public health in Plymouth, but does she recognise that in order to continue to deliver in that way, they need confidence to plan ahead? What guidance can she offer primary care trusts to continue to prioritise spending to address health inequalities?

Caroline Flint: I am very pleased to inform the House that in this financial year Plymouth PCT replaced previous health action zone funding with a recurrent allocation of £933,000. In addition, Plymouth secured £966,000 of neighbourhood renewal fund money to tackle health inequalities. That is a total of £1.899 million of funding—twice the amount originally allocated in the choosing health fund. Stretch targets have also been set for the number of healthy schools within the area and also for the reduction of smoking and pregnancy in Plymouth. I congratulate those involved in all those endeavours.

Alison Seabeck: Does my hon. Friend agree that tackling obesity—commonly found, as in Plymouth, in areas of the greatest health inequality—is also helping to deal with the alarming growth in diabetes? That being the case, does she acknowledge the importance of the research being carried out across the country, but particularly in Plymouth by the Early Bird project? It is looking—uniquely—in the long term at obesity and diabetes across social backgrounds, and it needs further funding.

Caroline Flint: We are acutely aware of the link between obesity and the development of type 2 diabetes. That explains our work in healthy start, which I am pleased to say was trailed to good effect in the south-west and went national last November. It is a way of encouraging better eating habits from the cradle onwards. There is also the healthy schools initiative. Of course we support research, but there is a point at which we know what the reality is and we have to get on with dealing with it.

HIV/AIDS

David Borrow: What action her Department is taking to improve HIV/AIDS prevention and education programmes.

Caroline Flint: The Department is continuing to target HIV health promotion towards the most "at risk" groups in England—namely, gay men and people from African communities. In 2006-07, we made an extra £1 million available to strengthen our HIV work for those groups.

David Borrow: Does my hon. Friend agree that work needs to be more targeted at younger gay men? It is important to emphasise that contracting HIV does not mean simply taking a pill a day, when everything is okay. Drug treatment for HIV is very unpleasant and is not 100 per cent. effective, so we need to get that message through to younger gay men.

Caroline Flint: My hon. Friend makes an important point. There has been a large drop in diagnoses of AIDS and a 70 per cent. drop in AIDS deaths, but it would be ridiculous to suggest anything other than that HIV is something that has to be dealt with every day of a person's life in respect of the mix of drugs and treatments necessary. My hon. Friend makes an interesting point about the younger age group, many of whom are too young to remember the 1980s campaign and may have a false sense of safety about their future health. I would welcome my hon. Friend, along with the Terrence Higgins Trust, coming to the Department to discuss those issues.

Nigel Evans: Can I come as well?  [Interruption.] Why not? The Minister will know that the incidence of HIV/AIDS has quadrupled since 2000 and part of the problem is the Government's complacency about it. They announced a substantial advertising campaign last year, but it was many months late and in the end it was pegged back to a £4 million campaign. Would it not be far better if the Government now embarked on a substantial advertising campaign to prevent needless thousands of people contracting HIV/AIDS in the future?

Caroline Flint: I believe that the last Conservative Government had a review in 1995-96. It looked into the value of mass campaigns in respect of HIV/AIDS. After that review, it was argued that the approach should be targeted more at the particularly vulnerable groups most at risk of contracting HIV. That is the position that we adopted and we carry out that targeted work with the Terrence Higgins Trust and the African HIV policy network. Our recent campaign was about getting across a strong message that is appropriate for tackling chlamydia, gonorrhoea and other sexually transmitted infections as well as HIV. The message is: if you are having sex, always make sure that you use a condom.

Michael Fabricant: Is it not also the case that of the 7,450 new cases of HIV/AIDS in the UK only—of course, it is still far too many—2,356 arose through homosexual sex? Do not many of the cases of AIDS in the UK come from legal and illegal immigrants who enter the country already infected with AIDS? What steps is the Minister taking to liaise with the Home Office to ensure that infection from that source does not spread throughout the UK?

Caroline Flint: We want to work with all communities that are vulnerable to HIV/AIDS, and that is why we support the Terrence Higgins Trust and the African HIV Policy Network. HIV diagnoses have been increasing since 1999 for several reasons. First, test uptake has increased. For example, among gay men it has risen from 45 per cent. in 1997 to 80 per cent. in 2005, and among heterosexuals it has risen from 25 per cent. to 82 per cent. over the same period. More testing is important, and among those tested are people who may have been living with HIV for some time but in whom it is being diagnosed for the first time.
	We are not complacent about any of those areas. We have taken other action, including, for example, the testing of pregnant women. Some 95 per cent. of pregnant women with HIV are diagnosed and that has been enormously successful in preventing mother to child transmission.
	We are in discussion with the Home Office on several issues, but it is important not to stigmatise people and to do the best we can. We should also remember that we are a very low prevalence country, with lower rates than places such as Spain, France and Portugal, and we should be proud of our record in that area.

NHS Finances

Adam Holloway: If she will make a statement on NHS financial performance in 2006-07.

Tom Brake: If she will make a statement on NHS financial performance.

Ann Winterton: If she will make a statement on NHS financial performance in 2006-07.

Patricia Hewitt: The NHS as a whole is on course to deliver net financial balance by the end of this financial year, It continues to cut waiting times and perform well against key service targets. Our quarter three financial report will be published next month.

Adam Holloway: In 2006 and with much fanfare a shiny new hospital was opened in Gravesend. Given the projected year-end deficit for the south-east, what assurance can the Secretary of State give that the hospital is safe and that services will not continue to go elsewhere from it?

Patricia Hewitt: The new hospital to which the hon. Gentleman refers is just one of 70 new or rebuilt hospitals already under way, with many others to come. I hope that he will recognise that the enormous investment that we are making, including in the new heart centre that has just opened at Darent Valley hospital, illustrates the fact that we are investing record sums of money in the NHS—investment that his party opposed. We are not cutting services: we are improving them.

Tom Brake: I recently conducted a survey of all local authority chief executives in the UK about the impact of NHS budgets on their local authorities, 25 per cent. of whom said that NHS budgets were hurting them. For instance, Buckinghamshire county council estimated a cost shunt of £670,000 from the health service on to the local authority. Camden is seeing an increase in the number of hours of home care as a result of faster hospital discharges. What discussions has the Minister had with the Department for Communities and Local Government about the impact of NHS finances on local authorities and what action is she taking—

Mr. Speaker: Order. This is a supplementary question, not an Adjournment debate.

Patricia Hewitt: The hon. Gentleman reflects well the need for social services authorities and the local NHS to work closely together to provide even better care for the people whom they look after from both the local government budget and the NHS budget. We have increased both those budgets and my Department works closely with the Department for Communities and Local Government on that score. I hope that the hon. Gentleman will encourage Liberal councillors to ensure that they do not cut social services for vulnerable elderly people.

Ann Winterton: Notwithstanding the Secretary of State's earlier replies, I still cannot see how the undoubted deficits in this year's budget can be made up other than by cutting services. Mine is a predominantly rural constituency, and is she aware that my constituents will not take kindly to any cuts in services at hospitals in Macclesfield, Leighton or north Staffordshire, or at the Congleton War Memorial hospital? In addition, they will not accept cuts in the mental health services, which remain the Cinderella of NHS provision in this country.

Patricia Hewitt: In that case, I hope that the hon. Lady will welcome the recent opening of a new day-case unit and a new medical admissions unit at Macclesfield district general hospital where, in addition, a new MRI scanner has been brought into commission. Moreover, we have invested more in mental health services in every part of the country than any previous Government.

Geoffrey Robinson: Is my right hon. Friend aware that we in Coventry have received enormous benefits from the great investment made by this Government? We have a brand new hospital, and there has also been tremendous investment in mental health services. That continuing success derives in part from the city's MPs' ongoing close consultative relationship with the Department, which I hope will continue with her blessing.

Patricia Hewitt: I can assure my hon. Friend that that will indeed be the case.

Kitty Ussher: During the Christmas recess, did my right hon. Friend have the opportunity to read the Institute for Public Policy Research's recent report entitled "The Future Hospital"? One element of the analysis stated that, on average, patients stay in hospital a day longer if they are admitted on a Thursday than if they are admitted on a Sunday. What is her estimate of the savings that NHS trusts could make if they corrected that inefficiency, without jeopardising patient care?

Patricia Hewitt: I did have the opportunity to see that report. It confirms that the NHS would save nearly £1 billion every year if all hospitals ensured that patients went home as soon as they were clinically ready. That is what the best hospitals do already, and the report provides further confirmation that there can be no trade-off between better care for patients and better value for money. The two things go together, and that is what our reforms are designed to achieve.

Eric Illsley: What incentives are there for primary care trusts to try and balance their books? My Barnsley PCT has been funded under target for years, but it would have achieved financial balance by the end of this financial year had it not been required to pay £7 million to fund the deficits in Sheffield, Doncaster and Rotherham. How long is that money likely to be held by the strategic health authority?

Patricia Hewitt: My hon. Friend makes an extremely important point, which reflects the fact that only a small minority of hospitals and PCTs are overspending. Indeed, 50 per cent. of the NHS' deficit is concentrated in just 6 per cent. of its organisations, and it is unfair for that minority to overspend at the expense of the majority. That is why we are so determined to ensure that the NHS as a whole returns to financial balance, and that the minority of overspenders put their houses in order by making themselves more effective. They must deliver better care for patients and better value for money, and they must also repay the money that they have borrowed, as in the example that my hon. Friend gave.

Richard Taylor: What steps is the Secretary of State taking to promote more widely the valuable information contained in the NHS' quarterly "Better Care, Better Value" indicators? In particular, is she promoting that information to hon. Members, so that they can point out to their PCTs the benefits of prescribing generic statins? Is she aware that, in the league table of prescribing generic statins, the PCTs of two of her colleagues on the Front Bench are ranked 291 and 298 out of a total of 303? If they improve—

Mr. Speaker: Order. I have counted three supplementary questions already, and I think that the hon. Gentleman is about to ask a fourth.

Patricia Hewitt: The hon. Gentleman is right; the quality and value indicators that we published last year repay close study. That is why we have made them available on a website so that each PCT and hospital can see where they need to make their services more effective, and how they can improve patient care and free up money for new drugs and new treatments. I certainly commend the quality and value indicators to every Member, because they show, once again, how better care for patients can go hand in hand with better value for the record sums of money that the Government have invested in our NHS.

Fiona Mactaggart: In tackling the difficulties that some areas of the NHS have experienced with their finances, innovative programmes —such as the one in our accident and emergency department to help older people—are often the first to go, rather than traditional programmes. What can my right hon. Friend do from the centre to encourage innovative programmes, which tackle health inequalities and provide improved access to services, and to ensure that they are not the first out under the last-in, first-out programmes that sometimes seem to happen when dealing with health budgets?

Patricia Hewitt: My hon. Friend makes an important point. Sometimes, under the pressure of financial difficulties, local organisations understandably make short-term decisions that may undermine innovative programmes that give patients better care and prevent falls, injuries and disease in the future. They thus help to deliver better care with better value for money. We do not try to micro-manage every hospital and PCT from the centre, but we give guidance— [ Interruption. ] We do indeed give guidance to ensure that such innovation is supported.

Peter Lilley: Can the Secretary of State tell us what proportion of the additional money going into the NHS is being absorbed by large pay increases, not for categories of staff in short supply—for whom, as she knows, I have long advocated increases—but for groups of highly paid staff, including consultants and general practitioners who have received increases of between £14,000 and £25,000 a year? Before the increases the General Medical Council was sending out notices headed "Important information for medical graduates", which pointed out:
	"There are an average of 210 applicants for each advertisement for junior hospital posts. Many posts attract over 1,000 applicants."
	In the light of that fact, why were the pay increases necessary?

Patricia Hewitt: I am sure that the British Medical Association and its membership will note with great interest the right hon. Gentleman's desire to cut the pay of both hospital doctors and GPs. I am proud of the fact that about half the additional record investment that we have made in the NHS has gone on additional staff and better-paid staff. In the case of GPs in particular, the reason they are earning so much more with a Labour Government than they were under the right hon. Gentleman's Government is that they are doing so much more work, preventing so much more illness and caring for patients so much better.

Sharon Hodgson: I am sure that my right hon. Friend is aware that Gateshead Health NHS trust is one of five in the country that has innovated and now offers physiotherapy services over the telephone. I am sure that she will agree that that helps to reduce admissions by caring for people in the community, and that through such programmes money can be saved and lives transformed.

Patricia Hewitt: My hon. Friend is absolutely right and I very much congratulate the NHS in Gateshead on that innovation. There is no doubt that as more orthopaedic patients receive physiotherapy directly in the community, those who need surgery can also be treated much more quickly in hospital.

Norman Lamb: May I ask the Secretary of State about trusts that have massive historical deficits, often of more than 10 per cent. of their turnover? Nigel Edwards of the NHS Confederation said that for those trusts
	"financial recovery would imply such damage to patients that no sensible person would go for it. They would not compromise the survival of the people they serve".
	Is the Secretary of State intent none the less on requiring those trusts to clear their deficits within a specified period, irrespective of their current financial performance and irrespective of the impact on patient care?

Patricia Hewitt: I congratulate the hon. Gentleman on his promotion and welcome him to his new place on the Front Bench.
	I have made it clear all along that we expect the NHS as a whole to return to financial balance by the end of the financial year. For the very small minority of organisations with very serious and long-standing deficits, it would be quite impossible for them to return to balance within one financial year, so they are being given longer. However, the longer they take to return to financial balance, the longer other organisations—we have heard from one of the primary care trusts today—will have to hold back on some of their growth money to compensate for the continuing overspending elsewhere.

Lindsay Hoyle: Will my right hon. Friend ensure that the future viability of Chorley and Preston hospitals will not be put at risk through the transfer of work from those hospitals to the private sector? The issue is about capacity within those two hospitals and we do not want to see ward closures. Will she ensure that that work is not transferred?

Patricia Hewitt: The new independent sector care assessment and treatment service that is proposed for the north-west will deliver to my hon. Friend's constituents and many other patients a better and faster service and it will do so by providing capacity additional to the capacity already available within the NHS and by enabling NHS capacity to be used much more effectively.

Andrew Lansley: Does the Secretary of State agree that the financial stability or otherwise of NHS organisations is a fundamental measure of overall financial performance? Halfway through the last financial year, 134 NHS organisations forecast a deficit at the end of the year. Will she tell the House how many NHS organisations this year are forecasting a deficit?

Patricia Hewitt: The information, as at the six-month point, was published in that financial report, but we will update that next month when we publish the quarter three financial report. As I say, I remain entirely confident that the NHS will achieve overall financial balance and that more organisations will move towards financial balance this year.

Andrew Lansley: I am surprised that the Secretary of State did not tell us; the answer to the question is 175 NHS organisations this year. What is particularly worrying is that last year the situation deteriorated between month six and the end of the year. An additional 45 organisations went into deficit. Can she explain why she believes that fewer NHS organisations will be in deficit this year and how many she expects to be in deficit? If they remain in deficit, precisely what the hon. Member for Barnsley, Central (Mr. Illsley) described will continue to happen: the money for organisations across the country will be top-sliced and their growth money will disappear in order to fund continuing deficits.

Patricia Hewitt: I notice that the hon. Gentleman never has anything constructive to say about the need to get better value for the record investment in the NHS and nor does he ever support NHS organisations in making the difficult decisions that are needed to get better value. We are publishing quarterly financial reports on the NHS—we are the first Government to have done so—precisely so that we and the NHS can track the progress that is being made, see exactly what steps need to be taken and take account of additional factors, such as the further cuts in prescription drug prices that are coming through, to ensure that the NHS gets back on track financially and continues to improve services for patients.

Mental Health

David Taylor: What discussions she has had with ministerial colleagues on the funding required to establish a network of NHS psychological therapists.

Rosie Winterton: Improving access to psychological therapies formed part of ministerial discussions for the White Paper "Our health, our care, our say". The two demonstration sites that have been established will provide evidence for a business case on investing in local psychological therapy services across England and will form part of our discussions with the Treasury as part of the comprehensive spending review.

David Taylor: The Government have done a good deal to tackle the Cinderella status of mental health within the NHS, but there remain difficulties with access to psychological therapies such as cognitive behavioural therapy, where waiting times exceed 12 months in 90 per cent. of primary care trusts. Can the Minister please act to ensure that such talking therapies are made available to all who need them and not just to those whose employment prospects will be improved and, in particular, to widen access to marginalised groups such as children, adults in hospital or in prison and black and minority ethnic communities?

Rosie Winterton: My hon. Friend is quite right to say that waiting times are too long at the moment, particularly for CBT. The point of putting the demonstration sites together is to learn from them exactly what is working so that we can make the case to persuade other areas to follow that example. As well as improving the number of clinical psychologists, it is important to look at the part that other health care professionals can play, particularly in the case of the new graduate workers that we are bringing in, and to look at extra training for health care visitors, for example, so that they can reach out to some of the groups that he has outlined to make sure that they get access to these important therapies.

Simon Hughes: Will the Minister look at the effect of the delays in psychological services generally and cognitive behaviour therapy specifically on young people, including students? All the evidence is that young people going into early adulthood, particularly at universities and colleges, are the most likely to commit suicide or to self-harm. There are often long waiting lists and no local services available, even with the best will of the universities. Will she see whether she can either buy in more services or allow people to use other services locally to prevent a crisis or worse?

Rosie Winterton: The hon. Gentleman is quite right: it is important that we look specifically at younger people. There are many instances where different agencies could work more closely together. I am talking about some of the personal advisers through the Connexions services and some of the facilities available in schools. We need to look at how we can bring those more closely together to make sure that, when people need those kinds of services, we are able to provide them more readily than they are provided at the moment.

Angela Eagle: Will my right hon. Friend look closely at the positive results coming from pathways to work pilots, where cognitive behaviour therapy offered by the NHS, but paid for by the Department for Work and Pensions, is having an enormously beneficial effect in improving people's mental health and allowing people not only to re-enter the work force, but to be happier as human beings? Clearly, that needs to be available in the rest of the country. Will she also look at the evidence that this therapy can be offered not only by psychologists, but by other health care professionals such as nurses and health visitors?

Rosie Winterton: My hon. Friend is absolutely right. Part of the important work that is being done in the pathways to work pilots is making that connection with employers. There is a lot that employers can do not only to break down some of the stigma and discrimination that there is against people who have mental health problems returning to work and remaining in work, but to support them when they have those difficulties. Again, the demonstration sites, linking with the pathways to work project, show a way in which we can build that into the services that we provide more widely. She is absolutely right that, as I have said, there are other health care professionals who, with a little extra training, can provide some of these services extremely effectively.

Bedford Hospital NHS Trust

Alistair Burt: What recent representations she has received on the financial situation of Bedford Hospital NHS Trust.

Andy Burnham: There have been three parliamentary questions and the hon. Gentleman has written to the Secretary of State and to me on this matter. The Department has also received correspondence from other hon. Members and from members of the public. In addition, my right hon. Friend the Secretary of State visited the trust on 4 October and discussed these issues with staff.

Alistair Burt: I have also had a letter from the Minister's permanent secretary apologising for a misleading written answer that was given to me earlier. Is the Minister aware that, since the new year, Bedford hospital has had to instruct its doctors that no non-emergency case can be operated on in less than the maximum allowed time frame, that outpatient clinics are being restricted and that bed shortages are causing real concerns? All that is happening because of a need to fulfil an arbitrary time scale to combat an arbitrary calculated deficit. When my constituents pay so much for their NHS, why are they and all who work so hard at the hospital being put through such downright misery, and why is it so often the case that Government targets dictate to patients, rather than patients' needs driving the targets?

Andy Burnham: I acknowledge that the hospital has had a difficult time and that difficult decisions have been taken to get it back into financial balance. However, I hope that the hon. Gentleman welcomes the fact that the hospital is now in monthly run-rate balance—it is in balance or better on what is coming into the hospital. The hospital is also forecasting a year-end financial position that is close to break-even. I did not hear any mention of that in his question and nor did he acknowledge that no waiting time target will be breached. The waiting times that are being met in his constituency are significantly better than those with which he left us when his party left government.

Patrick Hall: Does my hon. Friend recognise that an agreement has been reached between Bedford Hospital NHS Trust and Bedfordshire PCT on moving to a 20-week maximum wait? An additional £500,000 has been allocated to the hospital for planning purposes to enable it to do that, which will represent steady progress towards the national target of an 18-week maximum referral time from GP to intervention. Is that not part of the progress that is being made in the NHS in not only Bedfordshire, but throughout the country, which is in sharp contrast to some of the negative stories that we have heard of late?

Andy Burnham: I pay tribute to my hon. Friend because he has supported and encouraged his NHS to make the kind of progress that he has described. The NHS in his constituency is making progress towards the 18-week target, as is the NHS in other constituencies throughout the country. Instead of celebrating the hard work of managers and staff in his area to make such improvements, Conservative Members simply decry their efforts and demoralise staff by making exaggerated claims of the difficulties. We hear talk of a save Bedford—

Mr. Speaker: Order.

Nadine Dorries: It has been reported in the local press that Bedford Hospital NHS Trust will be asking GPs to take over the provision of genito-urinary medicine and sexual health services. We know that reported cases of chlamydia, gonorrhoea and HIV are on the rise, and my GPs say that they have neither the training nor the facilities that would be required. More importantly, patients want to go to a hospital where they can have guaranteed anonymity. Will the Minister send out a letter to Bedford Hospital NHS Trust saying that GUM services must not be closed down at Bedford hospital and devolved to GPs?

Andy Burnham: I would just ask the hon. Lady and her Conservative colleagues to stop setting their face against any change to the way in which services are delivered in the national health service. They should consider the possibility—this might just be possible—that it might be in the interests of patients for some services to be delivered out of the hospital setting and closer to their homes. I encourage the hon. Lady to open her mind to a thriving future for Bedford hospital and to accept the possibility that some services might be better delivered in the community.

York Hospitals NHS Trust

Hugh Bayley: What assessment she has made of the likely effect of the North Yorkshire primary care trust deficit on health services provided by York Hospitals NHS Trust.

Ivan Lewis: As my hon. Friend is aware, the PCT is working closely with the trust and the strategic health authority to agree changes that will lead to more cost-effective services. These changes will lead to a better use of resources, with some patients being treated more appropriately closer to home.

Hugh Bayley: The national health service is based on the principle that care is provided on the basis of patients' clinical needs, not their ability to pay, so will the Minister reassure the House that the rights of patients in north Yorkshire will be protected, despite the PCT's deficit, and that they will retain access to the same range of NHS treatments, and experience the same waiting times, as NHS patients from other parts of Yorkshire and the Humber?

Ivan Lewis: I agree with my hon. Friend and congratulate him on adopting a constructive approach towards the difficult financial circumstances that his PCT faces. As difficult decisions are made to ensure that we get that organisation back into balance, it is important that patients continue to enjoy access to high-quality services. However, it sometimes might be more appropriate to provide those services in the community, so this might be an opportunity to make some of the changes that frankly should have been made anyway, irrespective of the financial pressures that the organisation faces. Of course, the interests and needs of patients must remain at centre stage, and the trust must maintain the national standards that are set down on the quality of patient care.

Robert Goodwill: Does the Minister think that it is fair that while NHS workers in York are bearing the brunt of the £77 million deficit in north Yorkshire, the nature of the contracts imposed on the PCT by the Government means that the new private Capio hospital in York escapes relatively unscathed?

Ivan Lewis: What is important is the fact that patients in the hon. Gentleman's area have access to high-quality services and are required to wait for as short a period as possible. If that means allowing constructive engagement between the NHS as a direct provider and the independent sector, leading to better treatment for patients in his community, I would have thought that he would welcome it.

Anne McIntosh: I am delighted that Capio is enabling us to reduce waiting times for certain operations, but will the Minister respond to the question asked by the hon. Member for City of York (Hugh Bayley), with whom I entirely concur? The issue is not about having services delivered by other providers in the hospital trust, but about unacceptable delays and clinical need being put on the back foot. Will the Minister please respond to that question?

Ivan Lewis: The waiting time targets apply in the same way in the hon. Lady's constituency as in the rest of the country. Indeed, if we look at the facts, we see that no patient is waiting longer than 26 weeks for in-patient treatment, compared with 1,317 patients who did so when we came into Government in 1997. I hope that she will acknowledge the two new CT scanners that have been delivered to the hospital, the replacement MRI scanner, the fully modernised accident and emergency department, the additional cardiac catheter laboratory, and the new day unit, which was opened only in December last year, not to mention the £6.1 million integrated breast unit on the York hospital site. These are difficult times, and there are difficult decisions to be made, but there have been massively increased levels of investment and performance since 1997.

Health Care (East Cheshire)

Nicholas Winterton: If she will make a statement on future access to health care services in east Cheshire.

Rosie Winterton: Central and Eastern Cheshire primary care trust is developing new health services that will enable patients to receive treatment closer to home.

Nicholas Winterton: I am surprised that my namesake did not refer to maternity services, because they are the subject of my question. Is the Minister aware that birth rates in east Cheshire, which is served by the Macclesfield district general hospital, have increased for three years in a row? Women are opting to come to Macclesfield, in increasing numbers, to have their babies. Does she not agree that if women show that preference, it is essential to keep in-patient paediatrics, maternity, obstetrics and other children's services in the Macclesfield district general hospital, in accordance with that decision? Will she ensure that those services in the hospital, which serves a predominantly rural area, are fully, properly and fairly funded?

Rosie Winterton: I was not aware of the massive increase in the birth rate that has taken place, but I am now. I also know that the PCT is exploring the possibility of linking some of the maternity and paediatric services in the Cheshire area. Obviously, in doing so, the PCT will have to satisfy the strategic health authority that it is meeting clinical standards, such as those set by the Royal College of Midwives, and can still provide a full range of local services. I understand that the hon. Gentleman is meeting Mike Farrar, the chief executive of the North West strategic health authority, on 12 January, and I am sure that he will make his views clear at that meeting.

Gwyneth Dunwoody: Is my right hon. Friend aware that in my constituency, which is part of the Central and Eastern Cheshire primary care trust, for the first time in 30 years, we shall have a totally new health centre in the middle of Crewe, an entirely new health centre in the middle of Nantwich, and a new centre in the middle of Sharington? That is a remarkable feat, and I hope that she will give credit to the remarkable negotiating skills of Professor Dr. Ong, who has managed the normally unachievable feat of getting vast numbers of general practitioners to work together.

Rosie Winterton: My hon. Friend is right to highlight some of the results of the Government's increased investment in the national health service, and the real benefits that it can bring to patients. I am glad to hear her praise the work of NHS professionals, too; perhaps the Opposition would like to take her lead.

John Baron: Further to the comments of my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton), the fact remains that maternity services in Macclesfield, like those in Salford and Bury, have not been selected to become centres of excellence in the "Making it Better" reconfiguration across the north-west. It has not escaped public notice that some Ministers are trying to have it both ways by pushing for service redesign at a national level while opposing closures that affect their constituencies. Is not the reason for that embarrassing inconsistency the fact that those reconfigurations take place in the absence of an evidence-based model of safe and accessible maternity care? Will the Minister respond to our call for the Government to engage in a national debate about such a model, so that much loved local services do not face closure without good reason?

Rosie Winterton: The hon. Gentleman will be aware that people who make decisions on the organisation of local NHS services consider what is the best care for patients in the light of the best value for money. We have produced national guidelines and a national plan for maternity services. There is a well established process for service changes, which naturally includes hon. Members expressing views on behalf of their constituents. In the case of maternity services in Greater Manchester, a final decision has not been made, but hon. Members are free to express their views and those of their constituents.

Andrew Miller: The hon. Member for Macclesfield (Sir Nicholas Winterton) and Members representing Cheshire and Wirral share an excellent mental health trust which, my right hon. Friend knows, has made a bid to become a foundation trust. When will we know the outcome of that bid, and can she assure us that services in east and west Cheshire and Wirral—an area covered by two separate primary care trusts—will be maintained at the same level or, indeed, improved in the new structure if foundation trust status is awarded?

Rosie Winterton: It is obviously a great credit to the mental health trust in my hon. Friend's constituency that it has been considered for foundation trust status, as that will allow it extra freedom to expand its services. The bids are being examined and a decision will be made as quickly as possible. I am glad that he supports his local mental health trust, which has made genuine improvements for patients in recent years.

Recruitment

Andrew MacKay: What recent estimate she has made of graduate unemployment among (a) nurses, (b) midwives and (c) physiotherapists.

Jeff Ennis: How many newly qualified physiotherapists there are; and how many of them are employed in the NHS.

Andy Burnham: Between May and September 2006, about 16,000 graduates qualified. Latest estimates suggest that about 60 per cent. of nurses, midwives and allied health professionals have found jobs, and the situation is improving. About 1,600 physiotherapists completed their training in 2006, and we are working with the Chartered Society of Physiotherapy to address local recruitment problems.

Andrew MacKay: I am pleased that the Minister acknowledged that there are local recruitment problems and difficulties, but he will be aware that in my constituency and elsewhere many physiotherapy graduates have failed to secure jobs, which is a huge worry, both for them and their parents. What else will be done to put that matter right, as it is a great waste of resources?

Andy Burnham: I appreciate the point made by the right hon. Gentleman. There have been problems in certain parts of the country in the recruitment of physiotherapists who have graduated in the past 12 months. We need to do more to find roles in the community for physiotherapists, but I am confident that there is a need for more physios around the country to help, as we keep saying, to provide care at the local level, to keep people out of hospital and to reduce delayed discharges from hospital. I therefore accept the right hon. Gentleman's general point, but the most recent returns to the Department of Health for his area show that 71 per cent. of nursing graduates and all midwifery graduates have found employment.

Jeff Ennis: Following the point made by the right hon. Member for Bracknell (Mr. Mackay), is the Minister aware of the predicament of my constituent, Rachel Smith from Shafton in Barnsley, who last year qualified as one of more than 90 physiotherapists at Sheffield Hallam university? The vast majority of those students have still not found gainful employment with the NHS. Nationally, 75 per cent. of last year's physiotherapy graduates have yet to find employment. Next year, Sheffield Hallam university will train another 120-plus physiotherapists, and my constituent would like to know from the Minister what is the point of continuing to train physiotherapists if the NHS is not going to employ them.

Andy Burnham: I am aware of the case that my hon. Friend mentions, and I accept his general point, as I did in answer to the right hon. Member for Bracknell (Mr. Mackay). There is pressure and a particular difficulty for people graduating in physiotherapy this year. My hon. Friend's PCT recently recruited six newly qualified physios, and a further six bank staff to provide on-call services, so there is evidence of investment in physiotherapy in his local area. However, we need to do more to help people find jobs, whether in social care or in health care. In some parts of the country, consideration is being given to a combined job bank of vacancies in social care and health care. Perhaps we can explore that in his region.

Stephen O'Brien: Graduate unemployment among physiotherapists stands at 68 per cent.—a waste of nearly £40 million on training. Two thirds of midwifery units are understaffed, yet 40 per cent. are taking on fewer graduates, and 70 per cent. of graduate nurses have not found jobs. Furthermore, we learn that the Secretary of State is planning cuts of 37,000 to NHS staff, dwarfing even our estimates of her staffing cuts, which the Government have, incredibly, tried to refute. Will the Minister tell the House whether graduate unemployment and consequent cuts to patient care are due to shoddy work force planning or short-sighted reaction to the massive cash crisis engendered in the NHS by the Government?

Andy Burnham: I read the nonsense about staff shortages that the Conservative party put out before the Christmas break—a fantastic piece of Christmas fiction. It claimed that 16,000 graduates could not find work. That is the total number of people who completed training last year. As I said in my answer, 60 per cent. of them say, in reply to the Department of Health, that they have found jobs. The Conservatives should stop scaremongering on these matters. They are trying to frighten graduates and NHS staff by exaggerated talk of NHS job cuts around the country. They are trying to frighten local communities with talk of accident and emergency closures, and maternity—

Mr. Speaker: Order.

Speaker's Statement

Mr. Speaker: The hon. Member for Hendon (Mr. Dismore) has sought the exercise of my discretion to allow him to make reference in his speech to a relevant case which is to be heard later this week by the Court of Appeal. In order to assist the hon. Gentleman, I have agreed to exercise my discretion in this case to allow him a passing reference. I remind the House that I judge each such application on its merits.

Human Rights Act 1998 (Meaning of Public Authority)

Andrew Dismore: I beg to move,
	That leave be given to being in a Bill to clarify the meaning of 'public authority' in section 6 of the Human Rights Act 1998.
	It has been immensely important that the Human Rights Act brought home, so to speak, the rights set out in the European convention. Before the Act came into force, British people had to go to Strasbourg to redress breaches of their human rights. However, in one respect the protection afforded by the Act has been less comprehensive than intended by Parliament. The problem has arisen because of the development of case law interpreting the meaning of "public authority" in the Act.
	Under section 6, it is unlawful for a public authority to act in a way that is
	"incompatible with a Convention right".
	The Act does not provide a list of public authorities to which the Act is applicable. Instead, it states in section 6(3)(b) that a "public authority" includes
	"any person certain of whose functions are functions of a public nature".
	During the passage of the Bill, statements by the then Home Secretary and Lord Chancellor made it clear that privatised or contracted-out public services were intended to be brought within the scope of the Act. The "public function" definition, we were told, emphasised the function rather than the institutional status of the body performing it.
	So, for example, it was considered that a private security company would be performing a public function if it were running a prison under contract with the Government. It would be within the terms of the Human Rights Act. But when a private security company is providing a service to another private company, it does not come within the provisions of the Act.
	Since the 1998 Act came into force, a series of court cases have turned on whether a particular private company or organisation providing services was within its ambit. The result has been to undermine, or even to overrule, the comprehensive and wide interpretation of "public authority" which was originally intended. One particular case has left utter confusion over that question—the 2002 case commonly known as the Leonard Cheshire case. The local authority-funded residents of a care home run by the Leonard Cheshire Foundation, a private charity, wanted to challenge the decision to close down the home and disperse the residents, who claimed that that broke their right to respect of their home under article 8 of the European convention on human rights. However, the Court of Appeal found that managers of the care home did not constitute a "public authority" within the definition of section 6(3)(b) of the Act, so residents could not enforce their human rights against the care home even though the council still held its obligations to them under article 8, regardless of its contract with Cheshire Homes.
	In 2004, after reviewing that judgment and other cases that had turned on the definition of "public authority", the Joint Committee on Human Rights concluded that the test that was being applied by the courts was "highly problematic". That has resulted in many instances of an organisation standing in the shoes of the state but without responsibility under the 1998 Act, leading to a serious gap in the protection that the law was intended to offer. That gap is not just a theoretical legal problem, but a problem with significant and immediate practical implications. As many services previously delivered by public authorities become privatised or contracted out to private suppliers, so the law has failed to adapt to that reality. The implications of that failure extend across the range of especially vulnerable people in society, including elderly people in private residential care or nursing homes, tenants in housing association properties, children outside the maintained education sector, or looked-after children in receipt of children's services.
	In its 2004 report, the JCHR examined several possible solutions, including: amending the 1998 Act to clarify the responsibility of organisations to protect human rights in carrying out public functions; protecting human rights through the terms of the contracts between public authorities and private providers of public services, backed by authoritative guidance on when an organisation was likely to be a "public authority" for the purpose of the Act; and the development of case law on the meaning of "public authority". The Committee's views were that amendment of the Act would be likely to create as many problems as it solved and would be too soon after the Act's implementation, and that guidance on the formulation of contracts and best practice would be helpful but could not provide a complete or enduring solution, so the Government should intervene in the public interest as a third party in cases where they could argue for a broad interpretation. Three years on from the JCHR's report, there have been a number of significant developments. In November 2005, the Government published guidance to local authorities on contracting for services in the light of the 1998 Act.
	In my next remarks, I am grateful to you, Mr. Speaker, for your earlier ruling on sub judice. The Government intervened in the case of the Crown on the application of Johnson and others  v. London Borough of Havering to argue that the meaning of "public authority" covers elderly and vulnerable people who are receiving care from a private provider on behalf of a public authority. The case considered whether local authority care homes that were transferred to the private sector remained public authorities in respect of local authority placed residents. The Government were unsuccessful, but the appeal will be heard later this week, on 11 and 12 January. In addition, the Government are consulting on the "public authority" question as part of their discrimination law review.
	I welcome those developments, but there remains an urgent need to ensure that our human rights law clearly protects vulnerable people. The British Institute of Human Rights has reported on treatment of residents of residential care homes that clearly amounts to a breach of their human rights. Cases include the circumstances of home closures or notice to individuals to leave homes, and inhuman and degrading treatment such as elderly residents being fed breakfast while on the commode. When such poor treatment occurs in privately run residential care homes, it is not satisfactory for residents to have to rely on interpreting a contract between a local authority and a home's managers: they should be able to enforce their human rights directly.
	In this Parliament, the Joint Committee on Human Rights, which I chair, has continued to take a close interest in the matter. We asked the Lord Chancellor about it during an evidence session on 30 October. In his Department's July 2006 review of the Human Rights Act, which was repeated to us in his evidence, the Lord Chancellor put forward the extraordinary proposition that "widening" the definition of public authority could have the effect of driving private providers out of the market.
	That was extraordinary because the proposal would not widen the definition, but be exactly on "all fours" with what the then Lord Chancellor told Parliament was intended when the Bill was introduced. Moreover, the appalling implication is that those in private sector care homes, who are probably more vulnerable to abuse than those in "in-house" facilities, are not to have a right to challenge that abuse in our courts, thus making them second-class citizens. Their numbers are growing as local authorities continue to contract out. The contractors' commercial interests are put before the decent treatment of the elderly and vulnerable.
	The JCHR raised the possibility of legislation to make it clear that
	"any person or body providing goods, services or facilities to the public, pursuant to a contract with a public authority, is a public authority for the specific purposes of the Human Rights Act".
	My Bill is in my name, not that of the JCHR, though its supporters include Commons JCHR members from all three parties represented on the Committee. I believe that the case for addressing the issue through legislation is stronger now than ever.
	The purpose of my Bill is unambiguously to reinstate the wide and functional interpretation of "public authority" that was understood by Parliament and Government alike to be the meaning of section 6 when the Human Rights Act was passed. The intention behind my Bill is to ensure that human rights protections apply comprehensively, directly and consistently to all those who receive public services from private providers, including the most vulnerable members of our society. I hope that the House will support the motion.

John Redwood: I oppose the Bill, which illustrates the trouble into which a well intended Government get when they decide to rely on the courts and human rights legislation instead of Parliament and representative democracy.
	It is good of the hon. Member for Hendon (Mr. Dismore) to highlight the gross inadequacies in the drafting of the original Bill and the way in which the Government's intentions have miscarried. I can understand why he is helpfully trying to get the Government out of their hole. It is instructive that Ministers, with all their access to legal advice and help, have not come forward with a similar measure, properly drafted by parliamentary draftsmen. They clearly believe that it is a treacle well into which they could sink deeper.
	I want to make a simple point. The hon. Member for Hendon is attacking the actions of several elected councils—quite a few of them are probably Labour councils. He claims that they do not stand up for the most vulnerable in their community. Surely we, in the senior representative democratic forum in the country, should believe in the democratic system and in putting right such problems in provision by democratic challenge in the council chamber and through the intervention of councillors over their officers and over the supervision of contracts. If too many councillors have consented to too many bad contracts and vulnerable people are being damaged, that is a disgrace and it should be sorted out in the normal democratic way. If the councillors responsible cannot sort it out, I hope that their electors will take the necessary action at the ensuing council elections to change the management.
	Surely the hon. Member for Hendon must accept that the matter illustrates only too well that reliance on the law and the human rights panoply does not work and that we need to get a vibrant democracy again so that, in each council chamber as well as in this Chamber, we can get justice for people and action from Ministers and ruling councillor groups who otherwise are not doing their job.
	 Question put, pursuant to Standing Order No. 23 (Motions for leave to bring in Bills and nomination of Select Committees at commencement of public business), and agreed to.
	Bill ordered to be brought in by Nia Griffith, Mary Creagh, Dr. Evan Harris, Mr. Douglas Carswell, Ms Karen Buck, Clive Efford, Angela Eagle, Joan Ruddock, Mr. Paul Burstow and Mr. Andrew Dismore.

Human Rights Act 1998 (Meaning of Public Authority)

Mr. Andrew Dismore accordingly presented a Bill to clarify the meaning of "public authority" in section 6 of the Human Rights Act 1998: And the same was read the First time; and ordered to be read a Second time on Friday 15 June, and to be printed [Bill 43].

Welfare Reform Bill (Programme)

Jim Murphy: I beg to move,
	That the Order of 24th July 2006 (Welfare Reform Bill (Programme)) be varied as
	follows:
	1. Paragraphs 4 and 5 of the Order shall be omitted.
	2. Proceedings on consideration shall be taken in the order shown in the first column of the following Table.
	3. The proceedings shall (so far as not previously concluded) be brought to a conclusion at this day's sitting at the times specified in the second column of the Table.
	TABLE
	
		
			  Proceedings  Time for conclusion of proceedings 
			 New Clauses relating to Parts 1 and 3 and 5; amendments relating to Parts 1 and 3 to 5 8.00 p.m. 
			 Remaining proceedings on consideration 9.00 p.m. 
		
	
	4. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at 10 p.m. at this day's sitting.
	This programme motion is the product of a conversation through the usual channels. One knife has been inserted to enable and protect business on a specific debate on local housing allowance and housing benefit. With that one knife, we shall be able to make good progress in a similar spirit to the progress that we made on a cross-party basis in Committee.
	 Question put and agreed to.

Orders of the Day

Welfare Reform Bill

[Relevant documents: The Third Report from the Work and Pensions Committee, Session 2005-06, Incapacity Benefits and Pathways to Work, HC 616, and the Government's response thereto, Cm 6861.]
	 As amended in the Public Bill Committee, considered.

New Clause 3
	 — 
	Assessment of limited capability for work

'(1) The Secretary of State shall require the Office of Disability Issues to publish an annual report on the operation of the assessment for limited capability for work under section 8 of this Act.
	(2) In preparing its report the Office of Disability Issues shall be required to consult
	(a) the Commission for Equality and Human Rights, and
	(b) such other organisations as the Secretary of State shall by regulation determine.'—
	 [Danny Alexander.]
	 Brought up, and read the First time.

Danny Alexander: I beg to move, That the clause be read a Second time.

Mr. Speaker: With this it will be convenient to discuss the following amendments:
	No. 71, in clause 17, page 14, line 44, at end insert—
	'(1A) For the purpose of subsection 1, a person would not be disqualified on the grounds of failing to take medication presented by such persons as the Secretary of State may by regulation define.'.
	No. 98, in schedule 2, page 54, line 12, at end insert—
	'( ) for a person to be treated as having a limited capability for work where it has been decided that he does not have a limited capability for work but he is appealing against that decision.'.
	Government amendment No. 18
	No. 99, page 55, line 39, at end insert—
	'( ) for a person to be treated as having a limited capability for work-related activity where it has been decided that he does not have a limited capability for work-related activity but he is appealing against that decision.'.
	Government amendments Nos. 26 and 47.

Danny Alexander: I am pleased to be here to move new clause 3, which relates to the personal capability assessment for limited capability for work. This matter was discussed in Committee, but some of the outstanding issues are of sufficient importance to be raised again at this stage of the Bill.
	New clause 3, which I am pleased to say also has the support of other parties, proposes an annual report to Parliament on the operation of the personal capability assessment. It would enable monitoring, testing and independent evaluation, all of which are sorely needed in relation to the revised personal capability assessment. I am sure that all hon. Members would agree that revisions to the assessment for entitlement to incapacity benefit—or employment and support allowance, as it seems likely to become—are sorely needed.
	It is fair to observe that quite a lot of good work has been done in the stakeholder groups and other groups that are making recommendations on the way in which the test should be changed, particularly to enable greater attention to be paid to the way in which it meets the needs of people with mental health problems or learning disabilities. In response to the recommendations that those groups have put forward, I would say, "So far, so good." But—and it is a big "but", as the Minister will not be surprised to hear—I have real concerns about the testing process that has been undertaken so far.
	Those who served on the Committee will remember that we had a substantial debate on the merits or otherwise of having independent involvement in the evaluation process for the revised personal capability assessment. The Minister contended at that stage that all that was needed was a series of dummy runs, as the Department was proposing. This would effectively involve running the new test alongside the old test, and observing the outcome. However, the reports that I have seen on the outcome of the first dummy runs are very worrying, which is why I have tabled the new clause to ensure that there will be a regular report to the House on the way in which the tests for deciding entitlement to benefit are operating.
	My first worry is that the process under which the dummy runs are being carried out has been shrouded in secrecy. I am told that a report has been made available to some of the groups involved in advising on the revision to the personal capability assessment. I tabled a parliamentary question before the Christmas recess asking the Minister to publish that report but, as far as I am aware, it has not been published. A copy has certainly not been made available to me.
	Secondly, the testing has been carried out internally by the Department for Work and Pensions and the contractor responsible for undertaking the assessment, Atos Origin, without any independent assessment or assistance whatever.
	It also remains a matter of concern that details of the Logic Integrated Medical Assessment—the computer program backing all this up—have not been made available to independent groups, and nor have details of the logic within the system whereby the answer to one question prompts the medical assessor to ask other questions. Full details of the report on the dummy runs and LIMA should be published. Questions of commercial confidentiality have been raised, which implies that perhaps those details cannot be published. My understanding, however, is that the copyright for the LIMA program is owned by the Department for Work and Pensions; it is not the private property of the company that carries out the assessments. Perhaps the Minister will correct me on that. Given the dramatic impact of the questions and the operation of the computer program on benefit claimants, I can see no barrier to making those details available to the House.
	It is of real concern that the evaluation of the dummy runs seems to be the main evidence that will inform the draft regulations, which we were told would be made available to the other place when it starts consideration of the Bill. In that context, it is important to place on record the concerns put to me by outside groups about the way in which the dummy runs have been carried out. As I understand it, fewer than 100 claimants were tested, which is a very selective and not necessarily representative sample. It is therefore hard to make like-for-like comparisons. Importantly, the process was not followed right through to the appeals stage. All Members will know from their constituency casework that the high number of appeals against personal capability assessments for incapacity benefit was one of the main reasons for the revision of the test. Some 50 per cent. of appeals against decisions on the personal capability assessment are successful. Unless one follows the new assessment process through to the appeals stage, to try to understand whether appeals against decisions made under it are likely to be successful, it will be hard to judge whether the new assessment process is better or worse than the old one.

John Redwood: Is not the period of transition the most dangerous time for the vulnerable people about whom we are talking? Will we not need some interim review of the new assessment process long before a year or more—as the new clause suggests—is up? If this is such a comprehensive reform, how will we deal with it quickly if it starts to go wrong?

Danny Alexander: The right hon. Gentleman makes an important point. Two things need to happen. First, a much more comprehensive assessment of the revised PCA is needed before draft regulations to put it into practice are brought forward. That needs to involve independent outside organisations such as disability lobby groups and others that have had an advisory role.

John Bercow: The observation made by my right hon. Friend the Member for Wokingham (Mr. Redwood) also highlights the importance of widespread and continuing consultation. Will the order-making power of subsection (2)(b) of the proposed new clause be subject to the negative procedure of the House or to its affirmative counterpart?

Danny Alexander: I am grateful for that intervention— [Interruption.] I think that the answer to the hon. Gentleman is yes, as the Minister has pointed out from a sedentary position. The import of that is that the Office for Disability Issues, which has been established in the Cabinet Office to ensure that the interests of disabled people—

Anne McGuire: For the record, the Office for Disability Issues is in the Department for Work and Pensions, not the Cabinet Office.

Danny Alexander: I am grateful for the intervention, but in that case it is possible that the Office for Disability Issues is getting too close to the DWP. Nevertheless, it has a role in ensuring that disability issues are dealt with in a joined-up way throughout Government, which is why I suggest that it should be required to provide an annual report.
	Let me take up the second point made by the right hon. Member for Wokingham (Mr. Redwood). We shall need to get the assessment right in the first place, but we shall then need an ongoing process of reassessment, re-evaluation and reporting to ensure that it continues to work. We must make certain that the vulnerable people who, in many cases, are subjected to assessments continue to be discussed in the House, and are not left with what may turn out to be a thoroughly inadequate process.

Tim Boswell: The hon. Gentleman will not be surprised to learn that I agree very much with what he is saying. Is it not also important for the assessment to cover any anomalies or disparities in either the regional or the sectoral treatment of persons subjected to the assessment, given the possibility that different regions or groups of examining medical officers may take different views and may also have blind spots on particular kinds of disability?

Danny Alexander: The hon. Gentleman makes an important point. Regional disparities can arise in the wider debate about incapacity benefit for a number of reasons, and indeed we see regional concentrations of claimants in the statistics. I am sure that Members in all parts of the House will have observed variations even between individual doctors. I suppose that that is largely a management issue for the company that administers the assessment, but incorporating it in an annual report to Parliament would be a vital way of enabling us all to keep an eye on it.

Michael Weir: Is the hon. Gentleman aware of a report from Citizens Advice which draws attention to the difficulties already being encountered? One case involves a woman with myalgic encephalomyelitis. She was given only seven points at a medical examination, but the doctor himself advised her to appeal, and on appeal she was given 33 points. The difficulty appeared to lie in the computer system's inability to take account of variations from the standard. Should not the review look into that so that we can ensure that the computer program reflects the wide range of disabilities that exist?

Danny Alexander: The hon. Gentleman rightly refers to problems that have been identified in the existing system. In fairness to the DWP, I should say that its work, particularly in relation to some of those mental health and neurological issues, has made progress in terms of how fine-grained the assessment is capable of being. Nevertheless, while it is all very well for us to look at the words in the draft regulations—the 45 descriptors and so on—unless there has been proper and rigorous testing it will be impossible to know whether the new arrangement will work better or less well in practice than the current system, and that is the burden of the new clause.
	Let me return briefly to the question of the dummy runs that have been carried out so far. It would be useful if the Minister could give further details of the outcomes. I understand that while the new assessment would have given more claimants with mental health problems entitlement to benefit, on the basis of the dummy runs it would also have meant that many of those currently entitled to benefit owing to physical disabilities would no longer have been entitled to it.

David Ruffley: What does the hon. Gentleman think of the fact that the rise in the number of people who will be able to claim after passing the mental health descriptor is matched by a commensurate rise in the number who do not pass because they have not satisfied the physical descriptor test? Does he think it a rather odd coincidence?

Danny Alexander: The way in which the Government have described their intentions in relation to the revision of the personal capability assessment does not suggest that they wish an increase in the number claims for one reason to be matched by an equal fall in claims for another reason. It may well be a coincidence, and it may well mean that further work must be done to ensure that the test covers all possible reasons for claims. That is another reason why much more detailed scrutiny is needed, along with independent evaluation—not just dummy runs conducted by the company that is contracted to carry out the test, which strikes me as thoroughly inadequate. If we proceed on that basis, it will not lead to the outcome that I hope that all Members wish for. We need a much more detailed evaluation of the assessment, plus ongoing independent evaluation. If the new clause is agreed to by the Government—which is, perhaps, unlikely—or supported by Members, that will also allow there to be much more detail of how LIMA, the computer program behind the assessment, works in practice. That will be made publicly available, which will be of particular interest to lobby groups that are expert in dealing with certain conditions or impairments.
	I hope that Members will support the new clause, and if the Minister is unable to provide the reassurances that we think are necessary on what are important points, we will seek to press it to a Division.

Jeremy Hunt: I support new clause 3. Some of my arguments will echo those made by the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), but I make no apology for bringing important issues to Members' attention once again.
	The new clause is not particularly onerous. It will not cost the taxpayer any more, but it goes to the heart of the Government's commitment to make sure that the new employment and support allowance succeeds where incapacity benefit has failed. The solution to any problem must start simply with a correct diagnosis of that problem. For incapacity benefit and the new employment and support allowance, the crucial gateway is the personal capability assessment. There are, however, problems with that gateway, and they have produced the major issues in respect of incapacity benefit.
	The new clause simply requires the Government to publish an annual report on how that gateway is working, and to do so following consultation with key organisations such as the new Commission for Equality and Human Rights, which it is hoped will be as able an advocate of the concerns of disabled people as its predecessor body, the Disability Rights Commission.
	Why is this subject so important? Mistakes in how the gateway works cause enormous distress and cost the taxpayer huge sums of money. In 2005, 50 per cent. of appeals against incapacity benefit decisions were successful; that is an enormously high rate, and should be a real concern to the Government.
	Two examples given by the Citizens Advice illustrate that point. In one, a client with a severe skin condition lost incapacity benefit following a personal capability assessment that which awarded him five points, but at his appeal five months later he qualified for 16 points, although he then immediately received notice of another PCA medical examination. In another example, a woman with ME—myalgic encephalomyelitis—was given only seven points at a medical examination, but the doctor who carried it out advised her to appeal, saying that the computer would not allow him to award more; the client received 33 points at appeal. To borrow words that some Members might be familiar with from Christmas viewing of "Little Britain" episodes, "the computer says no" and people lose their benefit only to be re-awarded it later at great cost to the taxpayer as well as great personal distress.

Adam Afriyie: I am pleased that my hon. Friend raises the matter of assessments and what might be termed the 50 per cent. failure rate on incapacity benefit. Does he share my greatest concern that those with mental health challenges—in particular depression and bipolar depression—who are already undergoing enormous amounts of stress that is partially debilitating will be caused even greater stress if the facts and evidence do not come out, and if personal capability assessments are not reviewed on a regular basis to ensure that they are better?

Jeremy Hunt: I am grateful to my hon. Friend for those comments, and with his usual foresight he makes some of the points that I was going to make. He is correct that getting the gateway right is most important in dealing with people with mental health challenges—a subject that he takes great interest in and on which he has campaigned a great deal—and with those with learning disabilities.
	A second reason why it is so important to get the gateway right is that there can be no confidence in a new benefit if there is no confidence in the assessment process through which the benefit is awarded. That confidence is sorely lacking in respect of incapacity benefit at the moment. Why? First, it is because "limited capability for work" is defined as an essentially medical process. Many people would like to broaden it to include not just the responsibilities of disabled people to seek work when they are capable, but the responsibilities of society as a whole, so that it can play its part in including those people in the labour market.
	The elimination of prejudice—seen, for example, in the fact that 38 per cent. of employers are unwilling to employ a disabled person, which rises to 63 per cent. in respect of people with a history of mental illness—is a critical factor, as such prejudice limits people's capability to work. It has to be said that it is difficult to work out how it could be measured in an assessment process, but the new clause would at least allow that debate and might allow the assessment process to adapt to meet the challenges posed not by a person's impairment, but by the obstacles thrown in his or her path by a society still coming to terms with what it means to include disabled people in the mainstream.
	Another reason for concern about the way in which the personal capability assessment has operated historically is its ability to deal with fluctuating conditions such as bipolar disorder, which my hon. Friend the Member for Windsor (Adam Afriyie) mentioned. In a seminar on benefit reform that I organised last year, one of the participants who had bipolar disorder explained what happened when she went for her assessment. It is a fluctuating condition and she felt fine on the day that she had her PCA, but because she was worried that her assessor would not understand what a fluctuating condition was, she felt obliged, in her words, to "ham up" her condition to ensure that she secured the assessment result that she needed.
	A widespread concern about the current PCA process is that it does not adequately recognise not only fluctuating conditions but hidden disabilities such as autism and other learning disabilities. The National Autistic Society says that 40 per cent. of GPs do not have enough information to make informed decisions relating to autism. The result is that people with autism can often be mistaken for being belligerent and unco-operative. That is a real concern. Clause 8(4) states:
	"Regulations under subsection (1) may include provision... for a person to be treated as not having limited capability for work if he fails without good cause... to provide information or evidence in the manner in which he is required under such regulations to provide it".
	Someone wrongly considered to be unco-operative could lose benefit as a result of a lack of understanding of their condition.

Tim Boswell: Does my hon. Friend agree that that also applies to people with Tourette's syndrome, who might well be unable to conduct what we might call a civil conversation? Indeed, some have already found themselves victims, if I may put it that way, of antisocial behaviour orders because of the nature of their medical condition.

Jeremy Hunt: Absolutely. There is a whole range of conditions of which Tourette's is a very good example. My hon. Friend is right to draw the House's attention to those problems. I would also make the point that the range of conditions—incorporating hidden disabilities, learning disabilities, mental health problems and so forth—is such as to require a considerable amount of training in order that any assessor or doctor may understand those problems and make an adequate assessment.
	Let us consider what other organisations say about the problem. Mind says that
	"the majority of people who carry out PCAs will be locums. Most will be GPs who have done a day's work and will do PCAs in addition".
	It states that the assessors
	"certainly do not have much in-depth knowledge of mental health problems in the experience of our advisors who work with people with mental health problems".
	Mind continues by noting that it
	"spoke recently to one of our welfare rights advisors. She attended... 50 PCAs with various clients and in only one case did she find the person to have any understanding of what the issues were, to treat"
	the client
	"with respect, and to conduct the assessment at a pace that could give the person the opportunity to discuss as much as was needed".
	Mind's view is that, as a minimum, assessing GPs should have NVQ level 3 in mental health training. Citizens Advice has particular concerns about the ability of Jobcentre Plus personal advisers to identify appropriately and accurately the support needs of people with fluctuating and unpredictable conditions, or those whose conditions are likely to get progressively better or worse over time. Customers with mental health problems were seen as particularly challenging and even more experienced advisers did not feel confident working with them.
	As my hon. Friend the Member for Daventry (Mr. Boswell) said to me yesterday, this is not just an academic exercise. Some 40 per cent. of people on incapacity benefit have mental health issues as their primary condition, and if people who have them as a secondary condition are included, the number rises to nearly two thirds. So understanding mental health issues is key to effective reforms of the assessment process.
	A further concern is the relationship between the medical assessor and the decision maker. In Committee, the Minister said that the decision maker is not there to second guess Atos Origin but to check that procedures have been followed.

John Bercow: Before my hon. Friend develops that argument, I wish to press the rewind button and take him back to the important point that he was making about the requirement on individuals to provide information in the manner required by the terms of the Bill. He could have been referring—although I do not know whether he was—to clause 8(4)(a)(ii). If the Government are to do the right thing, and possibly avoid contravening disability discrimination legislation, it is essential that they should preserve maximum flexibility for the client as to the manner in which the information has to be provided. Why be excessively prescriptive unless it is essential to the evaluation process?

Jeremy Hunt: My hon. Friend makes an important point. That variety of means by which people may supply the information that they are required to supply is important, because the range of disabilities is so vast. The purpose of the new clause is to ensure that there is a process in place whereby it is possible to adapt and improve assessment as time goes on as a result of being able to learn from things that we are not able to predict.
	Another worry is to do with the timings of different stages of the assessment process. A claimant needs to go first through an assessment of limited capability for work, then an assessment of limited capability for work-related activity, and then potentially a work-focused health-related assessment. Those may sound complicated but to a claimant they are vital, because failure to co-operate at any stage could mean that the benefit is not awarded or that sanctions are applied, even if a claimant wishes to appeal against an earlier decision.
	The Government, to their credit, recognise the problems with the existing PCA. On the question of broadening the understanding of mental health conditions and hidden disabilities, the Secretary of State said to the Work and Pensions Committee in the spring that his understanding was that the Government should
	"involve the skills and expertise of a wider relevant range of healthcare professionals."
	The Minister said in Committee that
	"we will need to change the training in Jobcentre Plus and Atos Origin. When pathways is rolled out nationally, we will need to change the training given to personal advisers through the private and voluntary sectors."—[ Official Report, Standing Committee A, 24 October 2006; c. 162.]
	He also said that the 273 Atos Origin doctors will receive training in disability analysis.
	There is no shortage of worthy intentions, but I shall explain why, if the Government are to put those intentions into practice, they must accept the new clause. I refer the House to the details that we have been given of the new personal capability assessment process. I recognise that it is a draft and that the Government have done a great deal to try to adapt the present PCA so that it has a much greater understanding of hidden disabilities and mental health conditions. In particular, the new PCA has a revised section for assessing mental, cognitive and intellectual functions, and I want to give the House some examples of the judgments that will have to be made.
	I remind the House that people need 15 points to qualify for the employment and support allowance. A person who has difficulty learning a moderately complex new task gets six points, while one who has some difficulty learning a simple new task gets nine, and one who has significant difficulty learning a simple new task gets 15. Who on earth can tell the difference between those categories? The process is very difficult.
	Let us look at the section on understanding instructions. A person who has difficulty in understanding and carrying out moderately complex instructions gets six points, while one who occasionally has difficulty in understanding and carrying out simple instructions gets nine and one who frequently has difficulty in understanding and carrying out simple instructions gets 15.
	The section on forming relationships with other people is also relevant. A person who occasionally causes distress to others gets six points, while one who does so regularly gets nine and one who does so frequently gets 15. The extent to which a person causes distress to others in forming relations must be related in part to the resilience of his or her family members and carers. The judgments involved in assigning scores in these matters are very fine, even for people qualified in mental health matters, but they are vital, as they will determine whether a person is eligible for benefit.

John Redwood: My hon. Friend is making a powerful point about the gradations involved, and more of the detail will come out in the regulations. The annual report is intended to prevent people who need support from suffering injustice or lack of sympathy, but does he believe that it will achieve the Government's objective and succeed in reducing the numbers of claimants by 1 million?

Jeremy Hunt: In a way that he may not have intended, my right hon. Friend has touched on a point that I was about to make. People are worried that the arbitrary nature of the judgments involved may mean that the point at which people qualify for benefit is set at a level that will help the Government reach their targets, and that it is not based on objective medical assessments. I was a member of the Committee considering the Bill, and I do not believe that that is the Government's intention, but that concern is widespread. The credibility of the system is extremely important, and the new clause would allow an objective assessment to be made of whether it was working as intended. It would commit the Government to adopting a process of continuous improvement that would allow the system to be adapted so that it could fulfil its intended function.
	The concerns that I have set out are exacerbated by the fact that, according to a back-of-the-envelope calculation carried out in Committee, the amount of money per head in the pathways roll-out appears to be more than 40 per cent. less than that allocated to the pathways pilots. The resources available in the roll-out will therefore be nothing like what was available in the pilots, so will the Minister reassure us that the assessments will not be driven by financial considerations, and that the PCA will be adapted and improved to take account of the many valid concerns that have been expressed as a result of the failings of the current system?
	A simple way for the Minister to give the House those assurances would be for him to accept the new clause. It merely requires the ODI to publish a report, following proper consultation with outside bodies, on how well the assessment for limited capability for work is going. That would not be an onerous commitment and it would cost no money, but it would help to address disability organisations' many concerns about the operation of the current PCA. It would also put in place a mechanism to ensure that the PCA would develop, change and adapt to meet future concerns that we cannot predict now.
	In conclusion, there is no perfect assessment process, but the new clause would at least allow some light to shine on the more opaque corners of the new PCA. In doing so, it would not just achieve the Government's intentions, but carry the confidence of the wider public.

Roger Berry: It is a pleasure to follow the hon. Member for South-West Surrey (Mr. Hunt). Although I added my name to new clause 3, I shall not support it—certainly in its present form—and I shall explain why, but I want first to refer to amendment No. 71, tabled by me and several of my hon. Friends.
	Amendment No. 71 relates to clause 17, which addresses the circumstances in which a person can be disqualified from receiving an employment and support allowance. The amendment would provide that
	"a person would not be disqualified on the grounds of failing to take"
	prescribed medication.
	Unlike the two previous speakers, I did not have the pleasure of serving on the Committee, but I read a fair bit of its proceedings, which were important and encouraging. There was some debate about the phrase in clause 17 (1)(b):
	"failure without good cause to follow medical advice".
	There was discussion about the failure of someone to take medication for mental health problems because they felt that there might be adverse side-effects. Most Members would argue that non-compliance on the grounds that the medication could produce severe side-effects would not constitute a sensible reason for disqualification, so my amendment is a probing amendment to give my hon. Friend the Minister and my ministerial colleagues the opportunity to clarify the position. Would people who do not comply with the requirement to take medication be disqualified from claiming the ESA?
	I turn briefly to new clause 3, to which I put my name because it relates to real issues. The hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) made a number of points about the importance of getting the new PCA correct, and I very much agree. It is the gateway and is fundamentally important to the Bill. Some of the concerns that the hon. Gentleman expressed have been raised by many disability organisations. That is why at Work and Pensions questions yesterday, I commented that
	"the current system of assessment for entitlement to incapacity benefit has not been fit for purpose for many years".
	I therefore welcomed the new personal capability assessment but felt that because it was so central to the Bill it
	"should be subject to effective, long-term and independent monitoring".
	I was delighted that my hon. Friend the Minister for Employment and Welfare Reform replied:
	"It is essential that we have a better process to monitor the operation of the personal capability assessment and I look forward to discussing the details...as the Bill continues its passage through the House."—[ Official Report, 8 January 2007; Vol. 455, c. 9-10.]
	That was a welcome response.
	My concerns are widely shared among organisations such as Mencap, RADAR, Mind and others involved in the review of the PCA descriptors. In a briefing circulated to many Members, they point out that they support revision of the PCA. They think that the revised descriptors are a big improvement particularly for people with mental health issues, learning disabilities and/or an autistic spectrum disorder. However, those organisations have raised concerns about the assessments thus far and the hon. Member for Inverness, Nairn, Badenoch and Strathspey referred to that in his speech. The concerns relate to sample size, the fact that some conditions were not represented in the sample and the fact that the evaluation was not conducted by independent researchers but by the same DWP-contracted staff who carry out the PCAs at the moment.
	I am behind the sentiment in the new clause that we need an effective and independent monitoring system, but I disagree to an extent with the organisations that I have mentioned. They and others support the new clause, but I think that they have got it wrong on this occasion. The new clause asks for an annual report and it is not self-evident that we will need a report every single year from here to eternity. More importantly, the procedure will be rather cumbersome because the Office for Disability Issues will publish an annual report after it has consulted the Commission for Equality and Human Rights and any other organisations thought appropriate. As of today, the independent statutory body that should advise Government on disability issues is the Disability Rights Commission, but from October this year it will be the Commission for Equality and Human Rights. If the new clause were saying that there needed to be independent monitoring and that the DRC or the Commission for Equality and Human Rights would be the appropriate body to do that, that would be adequate. The idea that either of those bodies should produce a report and give it to the ODI, which would then present it to Government, is a strange way of going about things. I am sorry to say it, but I think that the new clause is ill thought out.
	I would certainly welcome an amendment in a different form on a different occasion if it encapsulated the key principle on which there is some agreement. I think that everyone, including the Government, agrees that there needs to be a mechanism to ensure that the experiences that we have had with assessments for incapacity benefit in the past are not experiences that can be repeated with the new PCA. That is crucial to an extremely important exercise that has support on both sides of the House. Although I cannot support the new clause, I very much hope that the Government will tell us how they intend to ensure that there is proper independent appraisal of the new PCA.

Tim Boswell: I welcome very much the new clause, the measured tones with which the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) introduced it and the substantial speech, which included important additional matter, in support of the new clause from my hon. Friend the Member for South-West Surrey (Mr. Hunt).
	It is also a pleasure to follow the hon. Member for Kingswood (Roger Berry). We have often spoken together on disability issues and, although we come from different political traditions, we find a lot to agree on. His specific point—why the Government's Office for Disability Issues, commendable as it may be, had to be cut into a process that could properly be dealt with by an independent free-standing Disability Rights Commission or Commission for Equality and Human Rights—was a cogent one. He also raised an important and valid point about the exact circumstances regarding the taking of medication.
	The debate is about the nature of the personal capability assessment process, but it will inevitably extend into consideration of the wider operation of the system in practice. That is what concerns most of us. The initial gateway hurdle and many things that go on in the process might leave vulnerable people with an element of disquiet or a feeling of dissatisfaction and lead to the system lacking public credibility or becoming discredited. We do not want that to happen.
	The hon. Member for Kingswood reminded the House—he was looking at the matter objectively, because, sadly, he was not on the Standing Committee—that there was a remarkable degree of consensus across those discussions. In that spirit, I do not wish to repeat the general arguments that have already been put, because the House should make progress.
	It is self-evident that the Government are looking for a system that is better than its predecessor, and that there are real considerations that have been raised in relation to the pilots—matters that were raised in Committee and elsewhere—that continue to worry people. Of those, because they are personal interests of mine, I single out only questions of fluctuating conditions, which have already been touched on, and of multiple conditions, where, although the system is meant to score them collectively, it might be difficult to grasp the overall effect on the individual. The difficultly when one has a protocol-driven system is that, almost by definition, it does not deal with the individual as an individual, and in that we have the potential makings of unfairness or an inappropriate decision.

Gordon Marsden: On the complex nature of disabilities that involve mental and physical aspects, is the hon. Gentleman concerned, as I am, that the revised assessment does not allow for the combination of scores from the mental health and physical descriptors? That might be one of the elements that causes problems with the conditions that he is outlining.

Tim Boswell: The hon. Gentleman is entirely right. There are issues of interaction where a physical condition gives rises to a mental condition, or a mental condition is accompanied by a physical condition. Frankly, the test of whether things work in terms of assessment should be whether the combined effect of the problems, seen over a period of time and not at one point, when the person happens to be having a good day, shows whether the person is able to operate effectively in work, whether they need support and if so, the nature of the support that they need to get back into work. Those are sensitive issues. Hon. Members have already said that this is not a precise science. We will not get things exactly right in every case. Doctors, even, can have an off-day. However, we need to assure ourselves that the system is going to work better.
	On the assessment process, I have a structural concern, which has been touched on, but which I would like to emphasise, in relation to any suggestion—in fairness, Ministers have not suggested this—of moving away from a series of strict criteria. Members with an educational background, including the hon. Member for Blackpool, South (Mr. Marsden), who just intervened on me, will be familiar with the distinction between a norm-referenced exam system and a criterion-referenced exam system. At the moment, we have the latter, at least in principle, and that is what is proposed in the personal capability assessment. However, I can imagine circumstances—Ministers might say that they are inconceivable—in which a future Minister, under financial or even political pressure, might wish to say, "We will introduce a norm. We are not going to have, by definition, more than 1.5 million people on employment and support allowance," and the tests will, in effect, be geared to deliver that result.

Danny Alexander: indicated assent.

Tim Boswell: I see the hon. Gentleman who moved the new clause nodding in acceptance of my concerns. It is important that Ministers put on the record that what I have set out will not arise.
	My concluding concerns relate to the involvement of the Commission for Equality and Human Rights. I do not want to go on about this or claim any particular virtues, but members of the Standing Committee will have heard me express, ad nauseam, my concern about human rights issues. I happen to think that it is rather important that such concerns are entertained on this side of the House as well as in perhaps more conventional or traditional quarters. It is important that those concerns be taken into account in our consideration of the Bill and its consideration in another place, and in all the regulations and the operation of the Bill.
	In that spirit—I touch on this briefly—I tabled new clause 1, which was not fortunate enough to be called for debate, although somewhat to my surprise, because it was not directly prompted by the organisation, it attracted the support of the Disability Rights Commission. It sought to set out some general principles—principles that the Minister himself acknowledged were broadly accepted in Committee—and to try to give them some flesh. I think that they could be summarised briefly without it being an abuse of the House. Decisions should be taken in the interests of a client. They should involve at least no detriment to either the health or finances of the client. The action proposed should be proportionate, and at all times the client should be involved—

Mr. Deputy Speaker: Order. I trust that the hon. Gentleman is referring to new clause 1 only briefly because it has not been selected for debate.

Tim Boswell: That was exactly why I was moving on from my point with the closing words that the client should be involved in the process.
	The process begins with the assessment procedure, which is the precise subject of new clause 3. I am worried that somewhere along the line we might fall at the human rights hurdle. I do not think that Ministers want that or that there is an agenda for it, but we must ensure that it does not occur. Whether that should be achieved by the new clause that I gaily put down, another measure or an understanding by Ministers, it is important that the matter be addressed, if only in terms of the concerns expressed by the hon. Member for Hendon (Mr. Dismore)—I do not often see eye to eye with him—in the past hour when he spoke to his ten-minute Bill. He expressed his concerns about the apparent exclusion of private sector contractors, of whom there will be a lot under the Bill, from the need to discharge their duties under the Human Rights Act 1998. I know that the Minister for Employment and Welfare Reform gave a reassurance in Committee that that would not happen and that it would make no difference whether the pathways contractor was part of Jobcentre Plus or a private contractor. It would be nice if he would give that assurance again. The Minister has also accepted that the new disability equality duty runs through the whole of his Department and that there is no question of any of the public departments opting out.

Danny Alexander: The hon. Gentleman makes an important point. It is equally important to put it on record that the same considerations about human rights and the disability equality duty should apply to Atos Origin when it carries out the functions of the Secretary of State in relation to the personal capability assessment. In fairness, the Minister made it clear in Committee that that would be the case.

Tim Boswell: I am grateful to the hon. Gentleman. Others wish to speak, so I will move on quickly.
	I am glad that new clause 3 has given us the opportunity to discuss human rights issues. Of course such issues should never be seen on their own and as being isolated from other aspects of public policy. However, the House rightly committed itself to the principles of human rights through its legislation. There is a good deal of common ground on the matter, so it would be distressing to all those who discussed the Bill in Committee and to hon. Members on both sides of the House if the high aspirations for welfare reform that are set out in the Bill were somehow to falter because the legislation did not work or was seen to be unfair. That is why I support new clause 3.

John Robertson: I wish to speak to amendments Nos. 98 and 99, which I tabled. I will be brief because I, if not everyone else, wish to comment on other groups of amendments.
	The amendments are quite important. They would insert new provisions in paragraphs 1 and 9 of schedule 2. Amendment No. 99 would allow regulations to make provision
	"for a person to be treated as having a limited capability for work-related activity where it has been decided that he does not have a limited capability for work-related activity but he is appealing against that decision."
	For the lay man, they would apply to someone who has been told that he cannot work, although he wants to work, and who feels that he can work and can prove that.
	The amendments would continue the current rules, which enable a person who appeals against a decision that he or she is incapable for work under the personal capability assessment to claim income support on the grounds of incapacity, albeit at a reduced rate, until the appeal is heard. As I read it, there is no equivalent provision in the Bill. Not including such a provision could increase the risk of poverty, given the poor standard of personal capability assessments at present. I doubt that it is the Government's intention to make people suffer in reduced financial circumstances that may have occurred through no fault of their own, so if the Minister is unwilling to accept the amendments, how does he propose that the anomaly in the benefits system be removed?
	I have some sympathy with new clause 3, which was tabled by the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander). Having said that, I have never been enamoured of annual reports, which usually end up being crammed together in the week before they are due, and which never meet the aims that everyone wants them to meet. If an annual report is simply there as a target, it should not be required.

Adam Afriyie: Does the hon. Gentleman not acknowledge that if an annual report is requested, and there is a requirement to report on progress in certain areas, it tends to focus the minds of the people in an organisation, especially if the report is to be put before Parliament, too? It tends to enable people to focus on the things on which they were intended to focus.

John Robertson: I thank the hon. Gentleman for his intervention, but my experience is that people pick whatever they want out of an annual report. They concentrate on the points on which they want to concentrate, and those points rarely bear any resemblance to those that the ordinary person in the street wants them to talk about. Having said that, the Government should introduce a mechanism that enables an external body to ask them questions, to which they must supply answers, but that happens anyway, and my hon. Friend the Minister would want his Department to supply that information. I should expect the relevant bodies that deal with people with disabilities to want to ask questions, and I expect that they would issue their own reports, saying whether the Government—or in this case the Department—were doing their job.

Lynne Jones: Is my hon. Friend not concerned, however, that evaluations are carried out by Atos Origin, and it is difficult to get access to independent information because of problems with commercial confidentiality? Is it not important that the Government propose a mechanism to overcome that problem?

John Robertson: My hon. Friend makes a good point, and I agree with it, but the Data Protection Act 1998 opened the way for Members of Parliament to receive information, in answer to questions, that we could not receive in the past. Will the Minister say whether, if we asked questions on behalf of the relevant groups, we would receive answers, despite the fact that my hon. Friend thinks that there would be some difficulty because of the 1998 Act and confidentiality issues? Obviously, medical conditions are a completely different matter; we could not get medical information. However, if an individual asked me, as their Member of Parliament, to act as their representative, could I get the necessary information? If I could not, and if the relevant bodies could not, how could we get the information that we were asking for, particularly given confidentiality considerations in medical cases?
	The hon. Member for Daventry (Mr. Boswell) made some good points about human rights. Unfortunately, although I wished to talk about human rights issues under part 1, my amendments were not chosen, but I think that I can sneak in my concerns about people who are terminally ill in our discussions on part 1. Their assessments are very difficult, and the great fear, of course, is the length of time that the assessments take, from start to finish. Will the Minister comment on that, even though the matter has only a tentative link to the amendments that we are discussing? It is an important question that needs to be answered. Members in the other place will ask such questions, so I am helping my hon. Friend the Minister by asking it. I urge him to look favourably upon my amendments, and to consider the concerns expressed by Members on both sides of the House. I congratulate my hon. Friend the Member for Kingswood (Roger Berry) on the excellent points that he made about his fine proposal, which, like my amendment, is a probing amendment.

John Redwood: When I first read new clause 3, I had two worries about it. First, I was concerned that the system would become a little bureaucratic year after year, if and when it settled down. Secondly, as I told the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), I was concerned that it would be too late if there were deep troubles in the transitional period. I have been swayed, however, by the moderate and sensible words of my hon. Friend the Member for South-West Surrey (Mr. Hunt), who has made an excellent job of understanding disability issues and speaking up for that community, and by the statesmanlike silence of my hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley), whose judgment I usually back. Consequently, I believe that there must be something in the proposals advanced by new clause 3, and it is not worth while rebelling.
	In the words of "Yes, Minister", the proposals are very brave and even heroic. If I had the difficult job of implementing them as a Minister, not only would I welcome the backstop provided by an independent body that could act as a conduit for criticism and appraisal but I would want a day-by-day feedback mechanism in the early months of the transition to make sure that I would receive a clean report from the longstop. The advantage of the longstop for the Minister is that it might enable him to fend off more urgent and telling requests from Parliament. I hope, however, that if things do not go well, Parliament will probe and ask questions before the annual review is produced. It would be sensible for the Select Committee to undertake such work, because we would want to stand up for the many vulnerable people who would suffer stress or distress if the transition was painful and difficult. In addition to the backstop, therefore, the Minister will definitely need intelligence day by day on the number of complaints, delays in the system, how much strain there is on staff, the relationship between outcomes and his perception, which surely informed the Bill, of the veracity and firmness of existing disability benefit claims, and the likely future pattern of such claims. He will need that intelligence as we go along.
	My hon. Friend the Member for Daventry (Mr. Boswell) has made a proposal relevant to our debate, because the excellent principles of new clause 1, which we are not debating, should help to inform the production of a good annual report, which is mentioned in new clause 3. Such open principles put the disabled person first and accept the Government's important point that many disabled people would like to work and would be better doing so, but need help and encouragement to find work. That should be the spirit of the annual report that would be produced under new clause 3. I should be grateful if the Minister responded to my intervention about the balance of the annual report. Its main purpose should be to protect the vulnerable and make sure that they are treated well and sympathetically, but there is a general policy point to be made about the fact that, wherever possible, work is preferable to other ways of spending one's time. The concept behind the legislation, which is accepted by Members on both sides of the House, is that we wish to promote sensible work for people with certain disabilities, and we think that we can do better than the systems adopted in recent years by various Governments.
	I will not embarrass my hon. Friends by praising them more or criticising their new clause. I can live with it, but the success or failure of the proposal will be determined by detailed implementation, strong ministerial control of the regulations, and an immediate feedback system so that if things go wrong the Minister will know at the earliest opportunity and can come to the House, make an honest confession and change the regulations.

Chris Bryant: I am sure it is true that all hon. Members have some experience of the operation of incapacity benefit and the way that the assessment process affects their constituents, but I suspect that those who have the most regular experience of that mainly sit on the Labour Benches, apart from the hon. Member for Blaenau Gwent (Mr. Davies), who is in his place and who perhaps one day will be an hon. Friend. Most of those who represent seats where incapacity benefit has coagulated in the most extreme sense over the past 20 years are Labour Members. In particular, that is because in former mining, ship building or iron and steel constituencies where those industries have collapsed over the past 30, 40 or 50 years, there are now a very large number of people on incapacity benefit.
	I had not intended to speak in the debate on the new clause tabled by the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) because many of the issues have already been set out. However, if I had gathered the same number of constituents from my constituency to have the same debate, it would have been entirely different from the tenor of the debate that we have had so far this afternoon. Many would agree with the view that the present system of assessment is wholly unfit for purpose, but they would do so from two completely different perspectives.
	Many who are users—who are in receipt of incapacity benefit—would say that the system of assessment is wholly unfit for purpose because too many people are losing incapacity benefit, but many other constituents would say that it is wholly unfit for purpose because it grants incapacity benefit to an awful lot of people who many of my constituents would consider not to be due recipients of that benefit. What that does to the economic life of the constituency and the economic expectations of young people coming out of school can often depress not just the local economic culture, but our economic aspirations.
	I wanted to speak in the debate because I have a strong memory of one man coming to my surgery three years ago. He stormed in and said, "It's outrageous. I had a heart attack in 1986 and I have been in receipt of incapacity benefit or invalidity benefit"—there have been various versions—"ever since. Now the doctors, on behalf of your Government, have said, 'You've got to go to work because you're fit to work.'" As other hon. Members would have done, I discussed with him whether the processes had been carried out properly, but eventually I had to say that I was not a doctor and could not judge whether he was fit for work or not. I could not make such an assessment.
	The man replied, "I knew it. You lot are a shower—a complete waste of time. The worst thing about your Government is that the benefit that you pay is so little that I have to go and mix cement on a building site every single day of the week!" I know hon. Members will laugh, but what is extraordinary is not so much that he said that, as that he chose to say it to me, and that he believed it was a perfectly legitimate complaint for him to make. He believed that he had worked all his life and that he should be in receipt of that benefit, in order to make his weekly package add up and to make his life worth living, in his regard.
	Of course, the vast majority of us, if not all of us—perhaps not all of the community that I represent, but the vast majority—would say forcefully that that man was working and should not have been in receipt of benefit, and that that form of fraud is the worst form of theft because it is against the whole community, not just against individuals. That is why it is vital that we change the system of assessment in the way that the Government suggest.

Lynne Jones: In citing that example, does my hon. Friend agree that it is important not to give the impression that there are large numbers of people in receipt of incapacity benefit who are fit for work? In all my time as a Member of Parliament, I have never experienced anybody coming to my surgery who would in any way fit into that category of claimant.

Chris Bryant: I agree that it would be utterly inappropriate for us to suggest that the vast majority of people who are in receipt of incapacity benefit are shirkers who are deliberately trying to avoid the world of work. In my experience, the vast majority would like to be in work if there were a means of the state helping them to get into it. The single most important thing that I would like to inject into the debate is the passion felt in many communities that have had a very rough time, resulting in historically high levels of deprivation, which want to get back up off their knees. They will only be able to do so if more people are able to get off benefits and into work.
	The hon. Member for South-West Surrey (Mr. Hunt), in a splendid speech, made an important point in response to the right hon. Member for Wokingham (Mr. Redwood) when he mentioned the possibility that the Government's system of assessment might be thought to have been designed to reduce the number of people on incapacity benefit or its successor benefit. That clearly should not be the case. The Government should not be trying to use their assessment process to force people off benefit and into work. However, it is equally right—many Labour Members will feel this more acutely than others because we have higher numbers of people on incapacity benefit—that the Government should be desperately seeking to enable more people who are on those benefits to get into work.

John Penrose: I would back up the hon. Gentleman by saying that not only Labour Members feel that. I appreciate that historically, as he said, many people claiming incapacity benefit and its predecessors coagulated in seats held by his party, but he should appreciate that one of the fastest growing causes of incapacity benefit claims has been failing mental health, particularly the fluctuating conditions mentioned by my hon. Friend the Member for South-West Surrey (Mr. Hunt). Those people are found in many other parliamentary seats—notably, perhaps, in seaside towns such as the one that I represent. The problem is shared on both sides of the House, and I am sure that all Members would want to reflect on the matters that he mentions.

Chris Bryant: I am sure that the hon. Gentleman makes an important point. However, he will make a mistake if he presumes that the reason for the high level of incapacity benefit claims in my constituency is that people have residual musculoskeletal problems from working in the mines, because remarkably few people of working age living in Rhondda have ever worked in a mine. More than 50 per cent. of people on incapacity benefit in my constituency are in receipt of it for mental health problems, and 50 per cent. of those are women. The pattern of incapacity benefit claims has changed dramatically, but the level is extraordinarily high—between a fifth and a quarter of all people of working age in my constituency are on incapacity benefit. However, I think that the hon. Member for Blaenau Gwent has the highest level of claimants in Wales. All sorts of hobbling, to use a valleys word, may go on, with elements of the black market making it possible for families to survive, but it is important that we try to change that culture of expectation; otherwise, I will feel that a Labour Government have failed in a socialist duty to tackle one of the greatest causes of poverty, which in my constituency results from incapacity benefit.

Michael Weir: The hon. Gentleman is making a fair point, but is he not also illustrating how the current system has lost the confidence of those who are using it and of the general public? It is important that we get the personal capability assessment right, and new clause 3 would ensure that the new system is not subject to the same failings as the current one.

Chris Bryant: I agree with the first half of the hon. Gentleman's comments, but disagree with the second half. It is clearly true, as I said earlier, that the current system has fallen foul of incapacity benefit users—those who are in receipt of it—and of the wider community, but that is why we need to get the system right now, not review it so frequently as to further undermine confidence in it because it changes year after year. Of course we need a system of review, but although I sympathise with the thrust of the new clause, I disagree with the idea of having an annual review, because such a constant process of change would not allow people to regain confidence in the system. I also believe, as the right hon. Member for Wokingham suggested earlier, that the review process should not be subcontracted to some other body but undertaken by a Select Committee, because the greatest expertise resides there.

Michael Weir: Will the hon. Gentleman give way?

Chris Bryant: I shall, but my last sentence was to have been the final one in my speech.

Michael Weir: Review does not necessarily mean change. It means ascertaining whether something works. That is important—conducting a review does not mean that the system will change every year, but it would ensure that the new system was not failing in the same way as the existing one.

Chris Bryant: The hon. Gentleman makes his point, but I would prefer a review every five years because when reviews take place and there is no change, people tend to question the point of reviewing.

Lynne Jones: Will my hon. Friend give way?

Chris Bryant: There is a general rule that one should use the word "final" only once in a speech but I shall now have to use it again.

Lynne Jones: New clause 3 calls not for an annual review but for an annual report, which is different.

Chris Bryant: Reports, reviews—there is not much difference between them. My point is broader and concerns the role of Parliament. I believe that the role of reviewing, revising and ascertaining whether we have got the assessment process is right should reside with the House and should not be subcontracted to another body. I shall therefore oppose the amendment tabled by the hon. Member for Inverness, Nairn, Badenoch and Strathspey.

Adam Afriyie: There is no doubt that hon. Members of all parties generally welcome the Bill, which acknowledges that viewing the capacity to work positively is an important step forward. That focus is crucial if we are to tackle some of the long-term problems that we are experiencing with incapacity benefit. The Bill is perhaps also an acknowledgement of the fact that the existing policy was not effective in removing people from long-term incapacity benefit. I cannot remember the exact figures, but the numbers increased hugely for people who had been on incapacity benefit for more than five years. The Bill is therefore an acknowledgement of a problem and of a failure of existing policy.
	The personal capability assessment is currently the only access point to the new employment and support allowance because existing claimants on incapacity benefit will not be transferred. It is therefore vital that the PCA is useful, effective and does not cause problems but leads to their resolution by identifying people's capabilities to work rather than their overall incapacities.
	However, too often, laws and regulations are made in the hope of achieving an outcome. As a member of the Science and Technology Committee with a background in business, I believe in evidence-based policy making. That is why we must acknowledge that laws and regulations—the PCA is largely a regulation—often have unintended consequences. In some cases, regulations have the opposite effect to that desired. Evidence is therefore vital and that produced so far is rather dubious. Only a small sample of assessments was made in reviewing the PCA—it ran only into the hundreds, if I am correct—and some conditions were missing. For example, nobody in the sample had disabilities on the autistic spectrum. I urge the Minister to consider new clause 3 carefully because if there is no evidence for effectively establishing the new PCA, surely it is important to produce a report to show its effectiveness, at least for the first few years until we are confident that people's lives are not being destroyed due to insufficient data.
	My key concern is about people who face a mental health challenge. If people who suffer from depression, are in remission from it or who suffer the other disorders and challenges that those with mental health problems encounter, are confronted with a PCA in which they are not confident, that could trigger another episode of their condition. So we need to be very careful about the PCA, and one way of ensuring that it produces the intended consequence of identifying people's capability for work is to report on it. There is a fundamental difference between a report on the outcomes of a policy and a review of that policy. New clause 3 calls for a report on the outcomes, not a review.
	If the Secretary of State and the Minister are confident that the new PCA will work, why do they oppose disclosure in the form of what I imagine would be a fairly straightforward annual report? Why would they feel the need to hide anything, or cover it up? Will the Minister take responsibility for any harm done to those with a mental health condition if the PCA is not effective or if it is not implemented correctly? From what I can see from the lack of data and evidence, and from the performance of the previous capability assessments in which 50 per cent. of appeals were upheld, the present PCA is based on a lot of hope and aspiration but very little fact or evidence. We have an opportunity here, and if the Minister will not accept new clause 3 in its present form, I urge him at least to give a strong indication that he will introduce proposals for some kind of report on the personal capability assessment element of the Bill.

Jim Murphy: It is a pleasure to respond to what has so far been a typically constructive debate. It has been consistent with the tenor of our detailed scrutiny of the Bill upstairs in Committee. Some might say that despite my contributions, we had some of the most informative and productive exchanges that I can remember in any Standing Committee on which I have had the pleasure to serve in my mere decade in this place.

David Ruffley: I have no desire to interrupt the hon. Gentleman's flow, but in a spirit of bipartisanship, may I ask whether he was aware that, after the first day of our deliberations upstairs, one of the policemen commented to one of my hon. Friends that it had been the most constructive and good-natured debate that he had heard in all his time on the upstairs corridor?

Jim Murphy: I was not aware of that. I had been labouring under the illusion that those fine members of Her Majesty's constabulary did not listen to the detail of our conversations, and that they perhaps participated in sudoku or some other leisure pursuit in Committee. However, it is enlightening to hear what the hon. Gentleman says. The success of our discussions was at least in part down to the contributions made by him and his Front-Bench colleagues, as well as by the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), by the hon. Member for Yeovil (Mr. Laws) in a passing visit and by the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Stirling (Mrs. McGuire)— [ Interruption.] I want to make some progress, but I must not forget the contributions made by my hon. Friend the Member for Glasgow, North-West (John Robertson) and those from many other airts and pairts of Great Britain.
	I am pleased to follow the hon. Member for Windsor (Adam Afriyie) in this debate because he played an important part in our deliberations in Committee and has rightly said that our approach to welfare reform should be evidence based. He is also right to say that incapacity benefit in its present form has not kept pace with the changing nature of disability, given the emergence of mental health conditions—particularly fluctuating mental health conditions—over the past two decades, and the changing gender make-up of the present IB customer base. About 40 per cent. of those on IB at the moment are women. We know that there has been a transformation in the sense that IB had previously been considered a legacy of our industrial heritage, but that is no longer entirely the case.
	IB has not kept pace with the changing nature of society and the legal rights that disabled people now enjoy in the United Kingdom. It has not kept pace with attitudes to those with learning difficulties, many of whom, it is now recognised, can play a productive role in the labour market. Progressive employers are now seeking ways to involve many people who have a fluctuating mental health condition or learning disability in active employment.
	The benefits system has not kept pace with such social changes as it should have done. Notwithstanding that, progress has been made. If we can continue as we did in Committee, without the traditional partisanship, it would be helpful.
	In passing, the number of people on incapacity benefit has decreased significantly recently—by about 54,000 in the past year. The most recent figure for the number of people on incapacity benefit is, I think, 2.69 million. If we had continued the trajectory as it was in 1996-97, however, that figure would be 4 million. Of course, much more needs to be done to support more of those 2.6 million to get off incapacity benefit.
	I also want to allay the fears expressed by the hon. Member for Daventry (Mr. Boswell) about the Government setting an arbitrary upper target for the number of people on incapacity benefit. He knows that that is not what the Bill is about, and it would be reactionary and wrong for this or any alternative Government to set an upper limit for the IB caseload. We have set a target of reducing the number by 1 million, but we are not seeking to achieve that through a legislative cap; we are providing the support to enable that as a public policy intent. That is what underpins the Bill.
	Let me comment briefly on the new Government amendments. As we have said, we want everyone to have the opportunity to work. That is why we have based entitlement to the support group on the most severe disability, which would make it unreasonable to require the person to engage in work-related activity. That underpins Government amendment No. 18. In relation to clause 9, the 46 descriptors in draft regulations, which have been provided in the Library of the House, reflect such a severity of disability.

John Redwood: One of the problems that will doubtless emerge is that different assessors, even in the same locality, will have a different view of how to score particular types of disability and whether people qualify for the support benefit. That is true of any system, but it is particularly acute in a new system, when many people's judgments are up in the air, and people worry about whether they have been more harshly treated than others. What will the Minister do to try to ensure greater consistency of judgment and greater clarity on how to score?

Jim Murphy: I will come to those points later. In general, however, the right hon. Gentleman is correct. Without being too churlish, he and I do not always find ourselves in agreement, but he is absolutely correct about the need for national consistency in assessments, not just in relation to incapacity benefit and employment and support allowance, but with regard to all sorts of other entitlements to benefits, including jobseeker's allowance.
	On Government amendment No. 18, we recognise that there are circumstances in which a person might not satisfy any of the 46 descriptors were they applied. We would still, however, want to treat them as having limited capability for work-related activity, and therefore as having access to the support group. As I said in Committee, paragraph 9(a) of schedule 2 allows us to provide in regulations for certain groups of people to be treated as having limited capability for work-related activity. For example, a person with a point of weakness, such as an aneurysm in one of the arteries to the brain, could put his or her life at risk by engaging in anything requiring even slight effort. We would automatically place such a person in the support group, even though they would not meet any of the 46 specific descriptors were they applied at that stage.
	Those circumstances do not necessarily imply that someone should be treated as having limited capability for work-related activity for an indefinite period. People's condition and indeed circumstances may well change, and we want to ensure that we can respond to those changes. The amendment makes that possible.
	Amendments Nos. 26 and 47 are concerned with consistency and continuity. They simply maintain long-standing benefit rules. Amendment No. 26 allows regulations to be made so that a person who is disqualified from receiving employment and support allowance because of his or her own misconduct can be treated as not having limited capability for work for the purposes set out in regulations. Consequently, he or she will not be entitled to the allowance for the period of disqualification. The provision can also confirm entitlement by treating the person as having limited capability for work.
	Importantly, that replicates the current approach in section 31(1) of the Social Security Act 1998, which provides for regulations to allow a person who is disqualified from receiving incapacity benefit on similar grounds to those that will apply to employment and support allowance to be treated, for prescribed purposes, as not being incapable of work and therefore not entitled to benefit. Amendment No. 47 provides for the repeal of that provision once the migration of existing cases to employment and support allowance is completed.
	I hope that that was as informative as it is possible for the explanation of technical Government amendments to be. Let me now deal with proposals that have attracted considerably more attention, starting with new clause 3.
	As was suggested by the hon. Member for Inverness, Nairn, Badenoch and Strathspey, when we implement a new policy—particularly one as important as this—monitoring must be a continuing process, and we certainly intend that to apply to employment and support allowance. The hon. Member for Daventry spoke of consistency in contractual arrangements, particularly in the private and voluntary sectors. He and other Members may have availed themselves of information placed in the Library, which explains how we intend to make that a reality.
	The hon. Gentleman also found himself in agreement with my hon. Friend the Member for Hendon (Mr. Dismore), who presented a ten-minute Bill earlier today. What surprised me most was the fact that my hon. Friend managed to present his proposals in 10 minutes, which was probably a first for him.
	The revision of the PCA has naturally attracted substantial interest. It is, of course, essential for us to evaluate the way in which it will work. The first stage of the test carried out in October and November was a limited evaluation of the revised descriptors and scores to enable us to begin drafting regulations. A second, more detailed, evaluation of the PCA will begin shortly. It will enable us to refine and fine-tune the recommendations of the working groups, while also ensuring, before we implement it, that the revised PCA constitutes a robust and accurate assessment of limited capability for work.
	Members in all parts of the House referred to the initial dry run of the descriptors. I hope that I can reassure the hon. Member for Inverness, Nairn, Badenoch and Strathspey and others. From the Government's point of view, this is work in progress. The initial evaluation was intentionally a small study, intended to confirm that the revised descriptors and scoring system would work. As those who served on the Committee will know, it has always been the case that further evaluation will take place as the task of refining the descriptors evolves.
	I stress that we are not drawing any firm conclusions about the effect of the revised descriptors on the benefit allowance or disallowance rate from such a small sample of cases. The next phase of evaluation, which is due to begin soon, will involve a larger and more representative sample, and representatives of the consultative group will be invited to take part. There will thus be a wider audience and a much greater number and variety of cases.
	I shall give way to my hon. Friend the Member for Kingswood (Roger Berry), and then to the hon. Member for Inverness, Nairn, Badenoch and Strathspey.

Roger Berry: At what stage in the process would my hon. Friend argue that what is occurring is an independent evaluation of the system, because that is essential if it is to be robust and successful?

Jim Murphy: As I said, I shall also give way to the hon. Member for Inverness, Nairn, Badenoch and Strathspey.

Mr. Deputy Speaker: Order. The Minister must respond to the first intervention before he takes the second one.

Jim Murphy: I shall address the independent nature of the assessment and monitoring shortly, but I anticipate that the points of the hon. Member for Inverness, Nairn, Badenoch and Strathspey will be of a similar tone to those of my hon. Friend the Member for Kingswood—although I might be wrong, of course—and I would like to respond to both.

Danny Alexander: I welcome what the Minister says about a further and more detailed evaluation and the involvement of independent groups. Will he also assure us that information will be made available to the House so that we can scrutinise all relevant matters as well as the independent groups? If that is done, the concerns that exist can be allayed before we move forward with draft regulations—or, indeed, with putting the new test into practice.

Jim Murphy: I will be happy to do so. We will certainly publish the report of the initial dry run before the Lords Committee stage, and we will hold discussions with the hon. Gentleman and others about the most appropriate time to inform this House and the other place about the specific outcomes of the second, and more substantial, process of utilising the new 46 descriptors. We will also seek to publish as much information as possible on the time scales that have been mentioned.
	Despite some of my comments and the hon. Gentleman's kind words in response to them, I am not attracted to new clause 3. Involving the Office for Disability Issues, which is of course part of the Department for Work and Pensions, by asking it to provide an annual report on the operation of the PCA would distort the natural accountability by placing at least some of the responsibility for operational stewardship elsewhere in the Department, rather than with those responsible for the specific policy and its operation.
	My hon. Friend the Member for Kingswood explained why he was not attracted to new clause 3, and there are additional reasons why the Government are not attracted to it. The Department is already required under disability discrimination legislation to produce a disability equality scheme. Active involvement of disabled people is already required in meeting the duty to promote disability equality. The additional obligations that new clause 3 proposes be imposed on the ODI would merely replicate the good work already being carried out by Departments, including the DWP, in meeting their duty to promote disability equality.
	I have spoken about the new clause's problems in respect of accountability. I have also referred to existing provisions on disability equality and the impact on disabled people generally. New clause 3 would create further problems in respect of the feasibility of requiring the ODI to provide reports on the operation of the assessment of limited capability for work. That is because of what the ODI would be asked to evaluate. The assessment of limited capability for work will inevitably involve clinical judgment because it will deal with the effects of medical conditions on individuals who have symptoms that cannot be measured precisely or exactly, such as pain. New clause 3 would require the ODI to review, evaluate and assess policy in the area of clinical judgment and would require the ODI to assess medical quality standards. Understandably, the ODI is not equipped to carry out such an evaluation process. It does not employ health care professionals, who would be needed to judge whether clinical judgment is being correctly applied.
	We have much more effective ways of carrying out that assessment. That brings me directly to the point made by my hon. Friend the Member for Kingswood. There are more effective mechanisms for independently evaluating the revised PCA to ensure that it effectively assesses limited capability for work, before it is implemented in 2008. We will also continue to monitor the effectiveness of the revised PCA following its implementation. For the first two years after it is implemented we will involve in its ongoing evaluation the independent experts from the technical working groups that advised us on the transformation of the PCA. For the period from 2008 to 2010, those independent experts will remain in place to offer assessment, challenge and observations about the operation of the revised PCA during the first two years.

John Penrose: The Minister has already said that he is willing to make public the assessments between now and the completion of the Bill's passage, but is he also willing to make public the data that he just described after that passage during the first two years of operation? It would then not only be a matter of consultation between him and the independent experts, but could be reviewed by the House and, more particularly, the Select Committee as well.

Jim Murphy: The hon. Gentleman has helped with our deliberations on the Bill at all stages and he has offered another reasonable suggestion. Subject to the caveat that there are no issues of commercial confidentiality—I cannot see how it would apply in this matter—we would be able to provide that information to the House and the relevant Select Committees. I hope that that also reassures the right hon. Member for Wokingham (Mr. Redwood) about micro-assessment and the ongoing day-to-day basis of how the revised PCA operates over the first two years. It is important that we learn about the changing outcomes of the appeal processes and assess whether we have got that right in the first two years. That provides an additional external check on how we manage the operation and effectiveness of the new PCA. After that time, we will still be subject to the usual channels of parliamentary scrutiny through Select Committees, the Public Accounts Committee and parliamentary questions.
	For all those reasons, we do not accept new clause 3 as we do not believe that it is a desirable way of auditing the application of the PCA. In addition to those protections and the independent and crucial parliamentary challenge that I have mentioned, the Government would reflect further at the end of the three-year period. Having gathered all the evidence and having learned from consultative groups and the observation of Select Committees about the nature of the appeal mechanisms, we would then consider the most effective way of continuing to keep on top of the issues with an active review and independent assessment of the continuing role of the PCA beyond 2010. I hope that that reassures the hon. Member for Inverness, Nairn, Badenoch and Strathspey enough to tempt him to withdraw the motion, but I am not sure that it will.
	I should like to move on to deal with issues raised by my hon. Friends, particularly on amendment No. 71. I am glad that my hon. Friend the Member for Kingswood has provided the Government with another opportunity to put our intentions on the record. We intend that the powers in clause 17 will be used only if a customer purposely and without good cause is found to have a limited capability for work, resulting from their own misconduct, failure to follow medical advice or failure to observe prescribed rules of behaviour. That includes misconduct leading to injury or a refusal to follow standard medical advice recommended by a doctor or hospital that could improve their condition and allow them to return to work.
	As stated in Committee, the purpose of clause 17 is to safeguard the benefit system against abuse where a customer deliberately decides not to follow standard medical advice in order to continue to receive benefit inappropriately. The clause is not an attempt in any sense to force people into accepting medical treatment or medication that they do not wish to take for genuine reasons—for example, on account of unacceptable side effects of drugs or fear of surgery. I hope that that reassures my hon. Friend the Member for Kingswood on the issues that he raised.
	Amendments Nos. 98 and 99 were tabled by my hon. Friend the Member for Glasgow, North-West who illuminated the Committee with observations on his experience in Glasgow. A league table of incapacity benefit has been published, so we know that the city of Glasgow has the constituencies with the highest level and the second highest level of incapacity benefit customers in the whole of the UK. Without wishing to enter the whole debate between my hon. Friend the Member for Rhondda (Chris Bryant) and the hon. Member for Weston-super-Mare (John Penrose), the changing nature of incapacity benefit is evident in that more women are now claiming it. But it is still the case that if one were to publish a list of the 100 parliamentary constituencies with the highest levels of incapacity benefit, 94 or 95, perhaps even 96, of them would be represented by Labour Members. I make no wider point than that, except to say that it is a result of the historical footprint of deindustrialisation and the fact that so many people were abandoned for a period when they lost their jobs and were out of the labour market for a prolonged time. As my hon. Friends have pointed out, if someone is on incapacity benefit for one year, they will on average be on it for nine years.
	My hon. Friend the Member for Glasgow, North-West asked about the Atos Origin operation. My hon. Friend the Under-Secretary, who has responsibility for disability issues, regularly answers parliamentary questions about the operational nature of Atos Origin and its procedures and practices. With a customer's permission, the IB medical report may be made available to Members of Parliament and that is the right level of confidentiality.
	My hon. Friend the Member for Glasgow, North-West also asked about terminal illness. He had a novel way of avoiding your wrath, Mr. Deputy Speaker, by admitting that he was widening the terms of the debate and hoping to sneak the issue past you. I hope to sneak a response past you in the same way, although it is of course open to you to call me to order. I hope that I may offer some comfort to my hon. Friend and also to my hon. Friend the Member for Dumfries and Galloway (Mr. Brown) who doggedly pursued the issue in Committee. I have given a commitment to talk to my hon. Friends in greater detail about this and it is our intention to fast-track those with a terminal prognosis through the system so that they do not have to wait the 13-week assessment period. We also wish to find ways to pay the benefit much more quickly. We process claims for DLA in about a week and there is no reason why we cannot seek to achieve a similar turnaround for those with terminal illness in respect of ESA.
	At present a person who is claiming IB or IS on the grounds of incapacity for work and who does not meet the PCA threshold has the option of either claiming IS at a reduced rate, set at 80 per cent. of the usual personal allowance, or of claiming jobseeker's allowance while they are appealing against the PCA decision. That is because many customers believe that they will prejudice the appeal if they are seen to be claiming JSA, which has rather more onerous conditionality requirements than IB.
	For ESA, we have decided to simplify the system. Where a customer does not satisfy the PCA, but continues to provide medical advice that they should refrain from work, entitlement to ESA at the assessment phase rate will continue pending the outcome of the appeal. That is a unique feature of the decision making process for social security, as normally when a person is not entitled to benefit it ceases and would be reinstated only when an appeal tribunal rules in the customer's favour. Customers will be subject to ESA conditionality, not JSA conditionality, pending the outcome of the appeal. I hope that that reassures my hon. Friend on his important amendment. Amendment No. 98 is therefore unnecessary and I hope that my hon. Friend will not seek to press it.
	Amendment No. 99, as has been suggested, goes much further than amendment No. 98 in that it seeks to treat people who have shown that they do not meet the criteria for limited capability for work-related activity as if they do so, solely because they are appealing against a decision that they do not. The effect would be to enable people in that position to receive a higher level of benefit and also not be subject to the normal conditionality regime simply because they have entered the appeals mechanism. I suspect that that is not the purpose behind the amendment and I again invite my hon. Friend not to press it.
	In conclusion, I have outlined the reasoning behind the technicalities of the Government amendments, and sought to reassure my hon. Friend the Member for Kingswood about our intentions in respect of medical treatment. In addition, I hope that I have reassured my hon. Friend the Member for Glasgow, North-West about his specific and important concerns, and that the hon. Member for Inverness, Nairn, Badenoch and Strathspey accepts that there will be parliamentary scrutiny in the important period between 2008 and 2010. At the end of that period, the Government will table proposals to ensure that the right of independent and parliamentary scrutiny is further enshrined so that the effectiveness of the revised PCA, which is central to the introduction of the employment and support allowance, can continue to be assessed.

Danny Alexander: This has been a good debate, especially in respect of the need to secure continued independent assessment and scrutiny of the revised PCA. I welcome the Minister's response to our criticisms of the initial dummy runs, and the problems that arose with them. I also welcome the fact that there will be another set of initial assessments, but the Minister's partial concession that independent involvement will continue for the first two years of the new PCA does not go far enough.
	As happened with the current system, many of the problems will not arise in the first two years of the new PCA. The Minister spoke earlier about the changing nature of disability over the years, and that is why we need an annual review. The hon. Member for Kingswood (Roger Berry) wondered whether the ODI was the right body for that purpose, but I think that, in consultation with other organisations, it could play that role very effectively. Therefore, although I welcome some of what the Minister said, I still want to press new clause 3 to a Division.

Question put, That the clause be read a Second time:—
	 The House divided: Ayes 226, Noes 307.

Question accordingly negatived.

New Clause 7
	 — 
	Participation in work-focused interviews

'(1) Members of the support group wishing to participate in work-focused interviews may do so on a voluntary basis.
	(2) The Secretary of State may by regulation define—
	(a) the maximum numbers of interviews they may attend,
	(b) circumstances in which participation in one or more interviews is not a condition of entitlement to the full amount payable under the employment and support allowance.'.— [Mr. Ruffley.]
	 Brought up, and read the First time.

David Ruffley: I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments:
	No. 3, page 8, line 1, leave out clause 10.
	No. 58, in clause 10, page 8, line 6, at end insert 'and
	(c) not in the assessment phase of a claim for an employment and support allowance,'.
	No. 116, page 8, line 9, at end insert—
	'(1A) Such an assessment may not take place earlier than 2 weeks after the assessments to determine limited capability for work or limited capability of work-related activity.'.
	No. 57, page 8, line 18, at end insert
	'in accordance with the choice and requirements of such a person'.
	No. 1, page 8, line 21, leave out paragraph (f).
	No. 2, page 8, line 32, leave out subsection (3).
	No. 87, in clause 12, page 11, line 22, at end insert—
	'(j) for notifying a person not subject to a requirement to undertake work-related activity that he may participate in work-related activity on a voluntary basis.'.
	No. 4, in clause 15, page 13, line 5, leave out '10' and insert '11'.

David Ruffley: New clause 7 relates to an extremely important group of individuals: those in the support group, who will enjoy the benefits of the new allowance. They are the most severely in need. They are quite separate from those in the employment group who, under the assessment in clause 9, are judged to be capable of work-related activity—not so support group members. However, even though, under the Bill, support group members are not under any obligation to undertake work-related activity, in a far-sighted and welcome way Ministers have made it clear that support group members may be able to volunteer for work-related activity and all the support and resourcing that comes with the undertaking of work-related activity.
	We all agree that there will be a fair number of volunteers from the support group who wish to avail themselves of the opportunity to undertake work-related activity. We know that because so many surveys, which Members on both sides of the House buy into, suggest that in the region of 1 million of the 2.7 million fellow citizens who are on incapacity benefit would like to work. They are desirous of working, and wish to make a contribution and to be better off for the benefit of themselves and their families. They want to exercise personal responsibility, which is part of the Government's agenda, allied with rights. We buy into that on the Conservative Benches as well and we are fully supportive of it. Those people want to get better. They want to get work-ready. We in the House should do everything that we can to help them. That is the purport of the new clause.
	The new clause provides that support group members should not be subject to the conditions that are imposed on employment group members who undertake work-related activity. There is a reason for that. It is entirely likely that a member of the support group will have severe and challenging conditions—by definition, more so than a member of the employment group. They might have fluctuating conditions. They might have quite a good week after they have volunteered. Things could be going swimmingly. They would be able to tick off securing their first work-focused interview. We hope that they would be enjoying the experience. However—as we discussed in great detail in Committee—with many fluctuating conditions, a claimant can have one really good week followed by one really dreadful week when, through no fault of their own, they are completely unable to face up to or engage in work or even the prospect of work.
	In that situation, we do not want someone in the support group who is doing something that they are not obliged to do—volunteering for a work-focused interview and, by extension, work-related activity—to be penalised because they have a bad week and are unable to satisfy the conditions of the work-focused interview. Perhaps they do not turn up on time, or do not turn up at all—again, through no fault of their own. We do not want someone to have their benefits docked or reduced in those circumstances, and I am sure that Ministers do not want that to happen, but that is implicit in the sanctioning regime in the Bill.
	There is a hint that sanctions—benefit docking—might be a disincentive to those in the support group when it comes to volunteering in the first place. Many surveys—one from Capability Scotland has been cited many times—show that at least one in two disabled people do not want to engage in work-related activity out of sheer fear that their entire disability benefits package might be reduced if they show any level of functionality greater than has been previously judged.
	New clause 7 would allow us to go the extra mile by ensuring that the fear of volunteering for work-related activity that a member of a support group might have, even though he or she would be under no obligation so to do under the Bill, would not put him or her off. Such people should not fear that they would be subject to a sanction if they showed some capability at a work-focused interview but were not able to keep that capability up—because of a fluctuating condition, for example—because they were unable to turn up and do the full raft of work-focused interviews.
	When we discussed the matter in Committee, the Minister for Employment and Welfare Reform was alive to the situation, which arises logically from the Bill's drafting. He observed—we have no reason to doubt these figures—that only about 1 per cent. of claimants under the pathways to work pilots have been subject to sanctions. Nevertheless, 1 per cent. of the big number of 2.7 million citizens could represent a lot of sanctioning, with some 25,000 people affected. We must remember that some of the people who could be sanctioned will have children. The Minister says that about one in six incapacity benefit claimants have children in their household. We have touched on the fact that sanctioning might not be terribly good news for families around the poverty line and we have all agreed that we would not want child poverty to be exacerbated by a sanction regime that kicked in to dock benefit and thus made a household poorer.

Natascha Engel: rose—

David Ruffley: I am very happy to give way to the hon. Lady. Her contributions in Committee were terrific and I am sure that her intervention will be equally fine.

Natascha Engel: I thank the hon. Gentleman for that build-up. I think that he slightly misses the point about the sanctioning regime and the difference between the support group and the employment group. It was made absolutely explicit in Committee—it is explicit in the Bill—that if a person in a support group voluntarily went into work-related activity, his or her employment and support allowance could not be sanctioned.

David Ruffley: I agree with the hon. Lady on many things, but I must disagree with her last observation. The purport of new clause 7 is to put in the Bill the very protection that she says is already in place. That protection is not in place. I will explain why I think that she is in error, although I will be happy to allow her to intervene, if she does not agree with what I say.
	In Committee, the Minister said that there were safeguards. He made it clear on more than one occasion that page 6 of the draft regulations with which he furnished the Committee referred to safeguards before a sanction was imposed. The problem that I have with that—the hon. Member for North-East Derbyshire (Natascha Engel) probably should also think that this is a problem—is that the text says:
	"The majority of safeguards are not set out in regulations".
	The safeguards are not set out in not only the Bill, but the regulations. The document continues by saying that the safeguards
	"are in operational guidance to ensure that where necessary they can be adapted if evidence suggests that they are not effectively protecting people".
	Page 6 of the document to which the Minister referred many times upstairs says that the safeguards are not in the Bill, or even in regulations, but in operational guidance.
	When the hon. Member for North-East Derbyshire made her intervention, she was probably referring to the assurances that were given in Committee about the way in which a volunteer from a support group could not be sanctioned. However, I am afraid that the Minister uncharacteristically missed the point in Committee when he said that in such circumstances it would be quite possible under the sanctioning regime for the sanction—the benefit docking—to be nil. However, that still is not good enough, because it implies that an individual from a support group who has volunteered falls under the sanctioning regime.
	The Minister also said that support group members who volunteered would have a right of appeal, which presupposes that they would be mired in the sanctioning regime. Such people would get rung up and would need to show good cause. They would have to go through all the rigmarole of arguing the toss about why, under the hypothetical example that I cited, they were not able to turn up for the full raft of work-focused interviews because their fluctuating condition meant that they were okay one week, but not so good in subsequent weeks, which was why they had not satisfied the requirements of the officials handling their case.

Natascha Engel: Let me make two brief points. First, the hon. Gentleman's comments presuppose that a work-focused interview would be mandatory for a person in a support group, which is not the case. Secondly, the sanction could not happen without a movement from the support group to the employment group. Without such a movement, all the points raised by the hon. Gentleman are completely irrelevant.

David Ruffley: We will have to agree to disagree on this. The hon. Lady is a vigorous and vibrant debater, and I leave it to outside groups to decide who is right. The advice that I have received from many of those who represent with great distinction the interests of those on incapacity benefit and the disability lobby says that there is enough ambiguity in the way in which the Bill is drafted for it to be useful for new clause 7 to be included, which is precisely why I am moving it.
	I thought that I had said this, but I will have to repeat it: those in the support group are under no mandatory obligation. They are volunteers. However, if those people make the decision to enter into the spirit of the regime that operates for those in the employment group, it is not clear that they will be free from sanctions and the sanction procedure. It is not good enough for the hon. Lady and her colleagues to say that there is a right of appeal. There is no doubt that an individual with a fluctuating condition who was a volunteer from a support group, even though he or she had no obligation to volunteer, could say, "I've got good cause because I have bipolar disorder and had a really bad week, so I missed a lot of the work-focused interviews." New clause 7 would make it explicit that a person in such circumstances would not have to show good cause within five days—let us remember, there is a five-day period in which to show good cause, although the time for appeal under most benefits is a month—or make a case in an appeal.
	We are arguing for crystal-clear clarity. I do not hesitate for a minute in saying that I hope that the hon. Lady is right that, in practice, those who volunteer from the support group will never be sanctioned. The chances are that it is 99 per cent. certain that they will not be sanctioned. However, I do not want to see such people having to go through the rigmarole of having a nil sanction against them or going through an appeal.

Danny Alexander: The hon. Gentleman makes an important point, which is why I support the new clause. He is not saying that it is not clear in the Bill that the support group is exempt from the sanctioning regime—that is clear. However, the Bill is unclear about whether people who volunteer from the support group to engage in work-related activity might be seen to be leaving the support group, with the result that they could be subjected to a sanctioning regime. That would cause people significant worry, which is why new clause 7 would be of benefit.

David Ruffley: The hon. Gentleman has just repeated what I said earlier. Of course, people in the support group would not be subject to the sanctioning regime, because they would be free from any requirement to undertake work-related activity. However, if those people were to volunteer to do work-related activity, it would be possible, under the Bill, that they would be subject to sanctions. That is absolutely clear.

Jim Murphy: My hon. Friend the Member for North-East Derbyshire (Natascha Engel) does not need me to support her—she spoke most vigorously in Committee—but perhaps I can come to her aid. I ask the hon. Member for Bury St. Edmunds (Mr. Ruffley) to reflect on what he says in the context of clause 11(1)(b), which specifically excludes any
	"member of the support group".
	Throughout our proceedings he has been on top of the detail of the Bill in a way that is very effective but, uncharacteristically, in his comments on this group of amendments he seems to have ignored a specific guarantee and protection in clause 11(1)(b).

David Ruffley: Of course I remember that we discussed the matter in Committee, but we did not get the assurances that we sought. If a member of the support group is involved in the work-related activity regime, the point is certainly arguable, and that is why we make the argument that we do.
	Under amendment No. 87, which is in my name and in the name of Government Members, there is a requirement to notify people of their right to volunteer. It is important to ensure that members of the support group, who are under no obligation to undertake work-related activity, have the clear right to be notified and told that they may undertake such activity, and so receive all the resourcing and help that goes with it. In those circumstances, notification is symbolically important; it underscores the fact that the Government and the law-makers in Parliament understand that those in the support group are valued and can get access to more support and help, as a result of undertaking work-related activity—and they are in the support group because the test says that they are so severely challenged by their condition that they are under no obligation at all to undertake work-related activity. Many things come with such activity, including cognitive behaviour therapy and the options outlined in the "choices" package in the pathways to work programme.
	In the context of that right to notification, I hope that the language used will be temperate, and that we will not fall into the trap of using some of the standard letter language included in correspondence sent to claimants in pathways to work pilot areas. It is worth putting on record once again, on Report, a letter, sent by officials, that was drawn to my attention and the attention of my hon. Friends by Mind and the Child Poverty Action Group. It said:
	"As your advisor, I need to meet with you to discuss how we can improve your chances of finding work, now or in the future. We want to make sure that you are getting the right support...It is important that you attend and participate in this interview. If you do not, your benefit may be affected."
	Outside groups found that language unfortunate. They suggested that it might make unhappy or unsettle claimants who might not want to be reminded too forcefully that their benefit might be docked.
	Someone who is under no obligation to take part in work-focused interviews because they are in the support group should be notified in a manner, and using language, that makes it crystal clear that they have a right to volunteer. The notification should set out the support available and make it clear that the person is not part of a sanctioning regime. They should not be told, "You're part of a sanctioning regime, but don't worry, because you've got a right of appeal and there'll be a 'nil benefit docking' decision." It should be absolutely clear that if such a person wants to participate in work-related activity there is no possibility of any sanction applying, especially as elsewhere in the Bill sanctions apply to everyone who does work-related activity.
	Two Liberal Democrat amendments in the group seek to delete clause 10, and I would like to put on record my party's feeling about them. The deletion of that clause might lead to wholesale chaos in the way in which assessments are managed at present. In addition, we should have regard to what the Minister said in Committee about the genuine potential need to hold three assessments—the initial limited capability for work test, the test for work-related activity under clause 9, and the health-related assessment for those who are in the employment group under clause 10. All three assessments could be required for those in the employment group. That would seem to involve a high level of complexity, or perhaps even duplication, and we debated the matter in Committee.
	Although I do not support the amendments, the logic of deleting clause 10 is presumably that the clause 10 assessment could then be folded into a clause 9 assessment, which would simplify matters and lead to a maximum of two assessments, rather than three, which is what we are faced with for some in the employment group. However, the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) will flesh out his thinking later.
	The fact that too many assessments are required is part of a bigger debate, which needs to be flagged up. Examples are legion of constituents of ours who have had to visit a medical centre to be assessed for a claim for incapacity benefit, and who have had to go there again for a disability living allowance assessment, and perhaps yet again for industrial injuries disablement benefit. It must be possible for Ministers and officials to continue their work to see how the benefit process can be streamlined and simplified. That is in the interests of the customer, first and foremost, but it is also in the interests of good government and the efficient dispatch of Government business. I commend to the House the amendments in my name and in the name of my hon. Friends.

Gordon Marsden: I wish to speak in favour of amendment No. 116, which stands in my name and those of hon. Friends. In view of the remarks of the hon. Member for Bury St. Edmunds (Mr. Ruffley), with which, in general philosophical terms, I totally agree, it might seem perverse that I should move an amendment proposing a time gap between the medical assessment and the work-focused health-related assessment, but I do so for good reasons.
	First, I understand that the Government have been flexible and thoughtful in their approach to the subject. In Committee, the Under-Secretary, the hon. Member for Stirling (Mrs. McGuire) said, in response to various concerns that were put to her, that the Government's preference was for the assessment to take place directly after the medical assessment, but that the Government were prepared to consider whether that was appropriate. Indeed, holding both assessments on the same day would be more efficient, and it would minimise the need for travel, among other things. Those are sensible and practical observations, but unfortunately they fly in the face of what many organisations involved in the subject believe, and they fly in the face, too, of the experiences that many of us have encountered in our advice surgeries.
	In that context, I pray in aid the strong reservations of Citizens Advice, which is, after all, a sort of second arm in respect of many of the issues that we come across in our constituency surgeries. Many of the problems that I deal with in Blackpool are referred to me from Citizens Advice, and vice versa. The briefing that it issued to Members says that it feels that the separation of the timing of the medical assessments and the work-focused health-related assessment was vital because the two assessments have very different purposes. It goes on to say that in the former the claimant is trying to prove eligibility for the ESA in general, and in the latter assessing work a person could do with the right support is apparently intended only for those allocated to the employment-related activity component. Furthermore, decisions on which component of ESA a claimant qualifies for will not yet have been made, and there is a risk that some people who are later allocated to the support component will have needlessly undergone an additional assessment.
	Those points are strengthened by the briefings that Members received from the Disability Rights Commission policy manager and the policy group of the Disability Benefits Consortium, which expresses strong concern about the timing of the medical assessment and the work/health assessment:
	"Currently, it is envisaged that the latter will take place either immediately after, or very shortly after, the former. We believe that this is unworkable."
	It is incumbent on everyone, not least the Government, whom I praise for incorporating many of the groups' recommendations, to reflect further on those issues. We should consider the human factor, as people are concerned about putting themselves forward for interview, which is a big step for them. I am not a psychologist, but it is a moot point whether it is better to obey the old principle of getting university finals out of the way in a short period and have a double whammy under the proposals or give people breathing space.

Tim Boswell: Does the hon. Gentleman not agree that there is genuine concern about the natural justice of such decision making and, indeed, confirmation of decisions? If one interview has taken place and a decision maker, who may not have conducted the interview, makes a decision, all subsequent interviews depend on the outcome and/or any appeal. It would be logical to follow due process and ensure that those operations were discrete, but I acknowledge that that could impose further stress on the claimant.

Gordon Marsden: In his usual balanced and fair way, the hon. Gentleman puts his finger on the dilemma. Of course, that is a danger, but it is outweighed by the points that he made earlier.
	We must be mindful of the way in which people approach such things. The medical assessment and the work-focused health-related assessment are very different things in the minds of the people who undergo them. The first involves getting over a particular hurdle or being seen in a particular context, but the second is a much more refining process. The Disability Benefits Consortium says:
	"Asking people to make such a shift in their thinking will almost certainly lead to a high number of incorrect decisions and assessments being made."
	The two-week period to which amendment No. 116 refers was suggested by NACAB. It is not set in stone—it is an issue for discussion—but I urge the Government to reconsider the principle of separating those two interviews.
	Turning briefly to new clause 7 and amendment No. 87, which was tabled by my hon. Friend the Member for Kingswood (Roger Berry), there were strong disagreements about the obligations on members of the support group. There is a broader issue at stake, and it is captured better by the amendment tabled by my hon. Friend than by new clause 7. It is an issue not just for members of the support group but for people who have been on incapacity benefit for a long time and wish to participate in such a process. I am passionate about the matter, and I was naturally interested in the exchange about whose constituency had the most IB claimants. The hon. Member for Weston-super-Mare (John Penrose) referred to seaside towns, and my Blackpool constituency has the 15th highest number of IB claimants. People scratch their heads and wonder why that should be the case, but in Blackpool many claimants with medical conditions imported their IB eligibility from former industrial areas. Many claimants in my constituency worked in the mining industry, and came to Blackpool in the 1980s and 1990s, so they have been on IB for 10 or 15 years.
	The philosophy of the Government's reforms is to give a sense of empowerment and openness to such people. I strongly urge the Minister to make more explicit in the Bill the fact that they should be given priority if they wish to opt in. They should not be excluded. I accept that if we wish to achieve quicker results that group will be more difficult to deal with, but it is important, not simply because of my constituents' personal circumstances but because a broader issue is at stake, that they should be kept in the frame.

Roger Berry: The House will be grateful for my hon. Friend's kind comments about amendment No. 97, as he has saved me the burden of having to speak to it myself.

Gordon Marsden: I am always happy to act in the service of the House.

Mr. Deputy Speaker: After that little interchange, I take it that the hon. Member for Blackpool, South (Mr. Marsden) has concluded his speech, so I call Mr. Danny Alexander.

Danny Alexander: It is a pleasure to follow the hon. Member for Blackpool, South (Mr. Marsden), who is eloquent and well informed, as well as the hon. Member for Bury St. Edmunds (Mr. Ruffley), who continues to display the consensual mindset that characterised his deliberations in Committee.
	This is an important group of amendments. I support new clause 7, which makes explicit the importance of the support group having equal access to the support offered by pathways to work—a matter to which I shall return. Amendments Nos. 1, 2, 3 and 4, which I tabled with my hon. Friends, as well as amendments Nos. 57, 58 and 116 to some extent, reflect on the appropriateness of the conditionality regime and the way in which it should apply to work-focused health-related assessments. Amendment No. 3, which would delete clause 10, is a probing amendment, designed to elicit a wider debate about those assessments and the regime in which they operate. Amendments Nos. 1, 2 and 4 relate to specific aspects of the clause and deal with concerns about timing, the conditionality regime and sanctions.
	As the hon. Member for Bury St. Edmunds said, and as the Minister made clear in Committee, there is a justification for some form of work-focused health-related assessment, which tries to do something different. However, there are tricky issues, as the hon. Member for Blackpool, South suggested, such as the appropriate timing and format of those assessments. There are arguments on both sides. The hon. Member for Blackpool, South advanced an argument for a delay, which might be appropriate for some people, but I am more sympathetic to amendment No. 87, which gives discretion to claimants and imposes a requirement on the Department or the company operating on its behalf to consult claimants on the timing of the assessment. It is important to stress that that assessment tries to do something quite different from the assessment of limited capability for work and the assessment of limited capability for work-related activity. Both those assessments are about determining entitlement to benefit. Again, as hon. Members remarked, having two assessments might seem confusing, although the Minister reassured the Committee that the process would be seamless.
	None the less, a work-focused health-related assessment which is designed to be more positive and tries to understand what health interventions might be appropriate to help someone get back into work, and which immediately follows the two assessments dealing with entitlement to benefit may well cause the problems that have been described. Equally, for claimants in constituencies such as mine, where the nearest assessment centre might be 70 or 80 miles away from their home, requiring two journeys to that centre within a period of two weeks raises the problem identified by the hon. Member for Bury St. Edmunds.
	In that context, I return to an idea that I suggested in Committee—that in the longer term the Department should consider enabling more of a core assessment. At least part of the medical assessment process for incapacity benefit or employment support or allowance, as it will be, is similar to that which might be used for disability living allowance and for industrial injuries disablement benefit, for example.
	If it were possible to develop some sort of core assessment, that might offer claimants greater convenience, as opposed to what I have experienced in my constituency, when individuals are required to go to the same assessment centre three times in three weeks for similar but slightly different assessments for different benefits. That seems an unnecessarily burdensome system as it applies to some of the most vulnerable people in society, particularly those who may, in the end, qualify for the support group. I do not think a hard and fast two-week period is right. Empowering claimants to make a judgment for themselves about what would be most appropriate in the circumstances is a more sensible way forward.
	There is one outstanding issue that arose in Committee and has not been adequately addressed by Ministers in relation to work-focused health-related assessments—the technical but important matter of the timing of those assessments, and how that relates to the application of sanctions. If, for example, someone takes part in their assessment for limited capability for work-related activity and believes that they should be in the support group, but the assessment finds otherwise and on that basis they refuse to take part in the work-focused health-related assessment, my understanding of what the Minister told the Committee is that although the decision would not be made until it had gone to the decision maker to check that the process had been followed properly, in practice the sanction could be backdated.
	In principle, that person could be subject to sanctions for not taking part in the work-focused health-related assessment, which followed immediately from the assessment for limited capability for work-related activity, which followed immediately from the assessment for benefit entitlement, even though the decision about their entitlement to benefit had not at that time been taken. That is a technical but serious issue, which I hope the Minister will clarify.

Natascha Engel: It is important to realise that the decision-maker is so called because he makes the decision. If the personal capability assessment is challenged, it will be referred to the decision maker to make a decision. I do not think it is possible for the sanction to be backdated to when the personal capability assessment was originally made.

Danny Alexander: I am grateful for that intervention. The Minister was not as clear as that in Committee. If he endorses those remarks in full, that will provide the reassurance that I seek and represent progress on our interchanges in Committee. Timing, decision making and sanctions, and how they apply are all important aspects of the work-focused health-related assessment that need to be resolved, as is the issue of appeals and how those apply.
	With reference to new clause 7, it is important that members of the support group be informed of their entitlement to take advantage of the support that is available through the pathways to work system. For reasons slightly different from those advanced by the hon. Member for Bury St. Edmunds, it is important that new clause 7 be supported. It makes it clear that people from the support group can volunteer to take part in the support group pathways to work, without thereby giving up their membership of the support group. It may be a technical point but it is an important clarification to make it clear to those people, as the Minister said, that there is no possibility of sanctions being imposed, even if they then choose to take part in work-related activity and so on.

Jeremy Hunt: Does the hon. Gentleman agree that one of the most important reasons for making it explicit in the Bill that members of the support group should be entitled to volunteer for work-related activity is the concern that many people have about the financing of the pathways roll-out? If the funding for the pathways roll-out is indeed 40 per cent. less per head than it was for the pilot programmes, there is a risk of claimants or customers whom it would be an expensive option to look after receiving second-best treatment. That is why writing it into the Bill that people in the support group are entitled to volunteer for the benefits of the pathways rollout is extremely important.

Danny Alexander: I am not sure whether the hon. Gentleman includes among his many qualities that of being a clairvoyant, but he introduces the point that I intended to address. He raises an important issue. It has been made clear on all sides that there is a general wish that any claimant of employment support allowance, whether a member of the support group or of the work-related activity group, should be able to benefit from the support that is available under pathways to work. However, there is a dilemma that needs to be crystallised so that the Minister has a chance to respond to it.
	If the burden of the new clause and the other amendments in this group is that the entitlement to take part in pathways to work should be made more explicit, it must also be clear that the support being discussed is available. I do not think I had a satisfactory answer from the Minister in Committee, if I may say so. The question is whether the commitment of funding to enable the scale and extent of pathways to work support that is hinted at by the amendments and by the Bill is available in practice.
	Calculations that I have made suggest that in the pathways to work pilot areas the average cost of providing support was £571 per claimant. Given that the Government have allocated only £360 million to the rollout of pathways to work and to other aspects of the Bill, such as the IT systems required for the new employment support allowance, that would suggest that it is proposed to spend less then £327 per claimant in the rollout. For new claimants alone, the level of resources will not be adequate to provide the same degree of service as has been provided in the pathways to work pilots, which are widely agreed to have been successful.
	I am concerned that unless we get some clear answers from the Minister about where the resources will come from to allow an adequate level of support through pathways to work so that, for example, all those who may be members of a support group can volunteer freely and of their own volition to take part in pathways to work, in the knowledge that support is available to them, the Bill could end up raising and then dashing the hopes of those people. All of us would wish to avoid that state of affairs. The lack of funding and of financial resource for the rollout of pathways to work, if it is to be extended to all claimants, including those in the support group, is a major weakness in the Government's proposal. I hope the Minister will take the opportunity to reassure the House that he has an answer to that.

Terry Rooney: I rise to speak to amendments Nos. 57 and 58, which stand in my name and that of my hon. Friend the Member for Kingswood (Roger Berry).
	There has been much talk, speculation and, frankly, mischief-making about the funding available under the pathways to work programme when it is rolled out nationally. I recommend that people read the report by the Work and Pensions Committee, which is an excellent piece of work that nails those ideas. I am concerned about the suggested figure of 1 per cent. as regards sanctions under the pathways to work pilots. My memory is that up to June last year, after two and a half years of the operation of the pilots, 36 people had been sanctioned. That is way below 1 per cent.—it is not even 0.1 per cent. or 0.01 per cent. That reflects the way in which the pilots have been run and the fact that they are the model for the future. Members of the Work and Pensions Committee visited many of the pilots, where it was staggering to see how people had had their eyes opened to opportunities that had been denied them, sometimes for decades. We should also remember—this in no way denigrates any incapacity benefit claimant—that many people in work with similar conditions to claimants have had opportunities to find ways through those difficulties that have been denied to too many other people for too long.
	Amendment No. 57 would give an individual required to take the work-focused health-related assessment some choice as to when it takes place. There are all sorts of reasons why that would be a positive move. I have a great of sympathy with the argument that it is a seamless process if the claimant has the personal capability assessment and then goes straight on to the work-focused health-related assessment, as the vast majority of people would probably prefer. There should, however, still be room for some choice. I should say that when the amendments were tabled it was not clear that the medical assessor will give the claimant an indication of their recommendation at the PCA. That is a welcome step forward. There will always be cases where it is crystal clear that the claimant should be in one or other of the two defined groups, but in those grey areas in the middle a fine judgment will eventually lie with the decision maker. Other factors will come into play for people who may be on medication, have child care responsibilities, or are unable to fit in two assessments in one day.
	When the reorganisation of the assessment centres was proposed a couple of years ago, the Under-Secretary, my hon. Friend the Member for Stirling (Mrs. McGuire), did a sterling job—forgive the pun—by listening to concerns expressed by Members on both sides of the House. Some people will still have a long way to go for an assessment, but the layout of the centres is now far better than what was originally proposed. However, there are still difficulties. In metropolitan areas with off-peak bus fare schemes, lots of people want to travel after 9.30 am and need to get back home before 3.30 pm. Introducing an element of choice as to when the claimant takes the work-focused health-related assessment would be beneficial and would address the lack of confidence felt by those in the disability community about the Government's commitment to the process.
	On amendment No. 58, there is still some confusion about when the sanction applies, despite the words of my colleague on the Select Committee, my hon. Friend the Member for North-East Derbyshire (Natascha Engel). As I understand it, the PCA and the work-focused health-related assessment take place in the first 13 weeks after a claim has been made and determine entitlement to a benefit from 13 weeks onwards, so the claimant gets a decision on a future benefit. Failure to do the work-focused health-related assessment can lead to a retrospective sanction after week 13 in terms of a benefit to which the person may still not know that they are definitely entitled. If the PCA and the medical assessor say, "I'm not quite sure—I think you're borderline", that person then has to make a decision on whether to take the work-focused health-related assessment straight away or take their chances and subsequently launch an appeal. Where does that leave everybody? We have heard many times today that 50 per cent. of appeals are successful, but we should bear in mind that not all refusals go to appeal and that the 50 per cent. success rate relates only to those that do. The figure is still too high, which gives rise to questions about the review process. If the system is to work properly, we need to take that element out of the equation as far as possible and get down to virtually zero appeals.
	For clarity's sake, people should have the choice of delaying the second part of the assessment pending the decision on the PCA so that they can see whether they have been judged eligible for the basic entitlement before they become subject to sanctions. That bureaucratic mismatch requires clarification. I hope that the Minister can reassure me, because we do not want the good work that has been done to be spoiled unnecessarily.

Tim Boswell: I rise in support of new clause 7, to which I have attached my name.
	The earlier part of the discussion, which got quite heated at times, related to benefits, to which any sanctions would normally be applied. When I raised the possibility of sanctions with the Minister in Standing Committee on 24 October, he helpfully replied:
	"Those are entirely fair points. The first of the hon. Gentleman's two points is captured by clause 11(1)(b) on the basis of any sanctions."—[ Official Report, Standing Committee A, 24 October 2006; c. 203.]
	I think that that was an attempt to reassure me, although he was less explicit on the second point, to which I shall return in a moment. It is pretty clear that somebody in the support group will not be sanctioned because they have refused to participate in a work-related activity interview, but that does not quite answer the point. As several hon. Members have said, there is uncertainty about situations where membership of the support group has not been confirmed because the second interview has not yet been formally decided.
	There is an underlying and greater concern further down the track. If somebody on the support group decides that they would like to volunteer, perhaps because they are finding their current position increasingly uncomfortable, they may fear that their application for a work-focused interview could trigger a reconsideration of their position under clause 9 as regards suitability for work-related activity.

Adam Afriyie: I was tapping my feet and gritting my teeth earlier because it is not clear whether someone from the support group volunteering to have a work-focused interview, the outcome of which was positive, would trigger some sort of mechanism. If it did not, it would certainly enter the mind of the person who was considering attending a work-focused interview that it might trigger an event.

Tim Boswell: That is the nature of my concern. There is an underlying fear that, if people who have been put, for objective reasons, on the support group—neither we nor the Minister want to write them off; that is not the accusation—volunteer, people may judge that as an admission of not needing to be on the support group, ergo they should lose their entitlement to benefits or enter the sanctions regime.
	Other points that I raised in Committee about the available resources are worth rehearsing—indeed, other hon. Members have done so. It remains my fear that, if resources are tightened for reasons beyond the control of the current Minister or, to be balanced, of the Administration, there may not be enough money to go round and the people in the support group would be the first to be cut out because they might not be perceived as cost-effective.
	A subsidiary concern, which the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) mentioned, relates to contractors. If the contract is not well written, there may be an incentive to drop the hard cases because they are expensive.
	It is not without significance that new clause 7 is co-signed by the hon. Member for Hayes and Harlington (John McDonnell), who convenes the Public and Commercial Services Union group in the House. There are wider concerns—perhaps political or subliminal—about the treatment of people on employment support allowance and those in the support group. Just as the PCS worries about two-tier work forces, I am sure that clients and claimants will worry about the possibility of different treatment and lack of access to facilities, especially resources, if they are in the support group rather than in the employment group. There is an even wider concern about equal handling from day to day and a worry that the Government or the system will write people off as if the easiest and simplest thing to do is park them in the support group on a reasonable benefit but with no expectation of change.
	My hon. Friend the Member for South-West Surrey (Mr. Hunt) spoke movingly about the matter earlier when he reminded everyone that we are not writing people off. Options and facilities—perhaps new technology—may come along and enable people to work in ways in which we have not imagined in the past to be practical.
	Of course, it is no kindness to claimants if they hammer on a door every day and say that they want a work-focused interview. The new clause would confine interviews to a reasonable number. We should not validate people's hopeless quests but we should not treat people as hopeless cases and they should always have the option of work-focused interviews and availing themselves of support.
	It is not only a matter of the claimants and their rights but of the Government's attitude. In a wider context, some of my hon. Friends have expressed concern, which I share, that, in matters of social policy—be it related to child poverty or handling disability or incapacity issues—the Government will be tempted to go for the low-hanging fruit; the people whom they can most obviously motivate to get off benefit and back into work. That is the easy part of the task, but, if we are interested in social cohesion, we should ensure that everybody is part of the system, that it is open to them and that nobody, however difficult the condition and however long the period on benefit, is written off or given any signal that the game is not worth the effort.

Natascha Engel: I am pleased to follow the hon. Member for Daventry (Mr. Boswell), with whom I enjoyed serving in Committee. Many of the points that have been raised hark back to those that were made at length in Committee.
	I want to speak against new clause 7. Despite the immense consensus in Committee, we are in serious danger of getting our legislative knickers in a twist. The new clause overdoes things and would achieve exactly the opposite of what we are trying to do, given that we all agree that the current system is inadequate to deal with the needs of those who are on incapacity benefit.
	As the hon. Member for Bury St. Edmunds (Mr. Ruffley) said, the majority of people on incapacity benefit want to go back to work. The Government are trying to facilitate exactly that in the Bill. They are doing that by establishing a support group and an employment group. The support group has that name because we are not trying to write off people on incapacity benefit who will receive employment support allowance.
	The support group will recognise and address the variety of different health needs, disabilities and fluctuating circumstances in which people find themselves. We also want to support people in the group not simply to remain in it for ever but to try to get work or engage in some sort of work-related activity. New clause 7 goes against the spirit of that and undermines everything that we are trying to achieve in creating the support group.

Adam Afriyie: We are attempting, through new clause 7, to untwist the Government's knickers by making it clear that people in the support group can ask for a work-focused interview without risking being drawn into the rigmarole of leaving the group. I am, therefore, not sure what the hon. Lady's concern about the new clause is.

Natascha Engel: I am worried and feel as if I am banging my head against a wall—perhaps I am not being sufficiently clear. There are two groups—the support group and the employment group. Those in the support group cannot have their employment support allowance stopped, docked or sanctioned. The hon. Member for Bury St. Edmunds explicitly stated that he understood that financial support given to those in the support group cannot be stopped. Expressing a desire to participate in work-focused interviews or work-related activity will be backed in the support group, but those are only two of many options available to those in the group.

Jeremy Hunt: We all agree that the purpose of the Bill is not to write anyone off. We also agree that different groups have different needs, which is the reason for establishing the support group and the work-related activity group. However, if we are not to write anyone off, surely that means that people in the support group—those with the most needs—must also have the opportunity to move away from benefit and engage in work. All that the new clause does is include in the Bill what is written in the explanatory notes, which state that people in the support group should be able to volunteer for work-related activity. The Opposition—and, indeed, many disability groups—fear that the Government's strong resistance to including that in the Bill suggests that they may not put their money where their mouth is and give people in the support group the opportunity and necessary resources to participate in work-related activity.

Natascha Engel: Again, I feel as if I am banging my head against a wall. I believe that the hon. Gentleman's point is already explicit in the Bill, as is the difference between the two groups. I am deeply frustrated tonight—and have been throughout the Bill's passage so far—that that has not been accepted. I feel strongly that it is important, given the differences in the needs of those in the support group, to leave flexible whether they remain in that group for the rest of their working lives or move out of it into other activities. Personal advisers will work with those in the support group—indeed, there will be constant work with them—unlike the position today for those on incapacity benefit.
	The flexibility and personalisation of the support for those in the group is fundamental to the success of the Bill. New clause 7 not only undermines the ethos of that but removes all the flexibility for people to move into the work-related group or stay in the support group, if that is what they need.
	I agree with other hon. Members about the importance of the language that we use—a matter discussed at great length in Committee. However, I do not believe that the language used in the letters that are sent out during and after the assessment process to individual claimants, customers or whatever we want to call them is an appropriate matter for inclusion in the Bill. I would absolutely reject that proposal.

Adam Afriyie: I had not intended to speak to new clause 7, because I thought that it was self-evident that it made a lot of sense and that it would create a clear pathway for people in the support group who choose, of their own accord, to go for a work-focused interview. Much of this debate has been about choice, and the hon. Member for Blackpool, South (Mr. Marsden) mentioned empowerment. It is clear that there are a lot of pressures on people in society today, and the greatest cause of unhappiness, stress and mental health issues such as depression is the feeling that one's life is out of one's control.
	There are 6 billion people on the planet, and 60 million people in the UK. There are very few identical twins. In a support group, there will be people with a positive frame of mind who, even though their PCA has suggested that they should remain in the group, will decide that they want to go through that door and take the opportunity to have a work-focused interview—as part of their own re-focusing of their life and their own positivity—without risking that action triggering a reassessment.
	Someone in a support group might decide that, because they were in a positive frame of mind and feeling good, they were going to go for a work-focused interview. However, they would be hesitant and nervous in case their being successful and being deemed to be okay to take some form of work might trigger a recalculation or reassessment of their entitlement to be in the support group. That would be a natural worry. It would be a hard-hearted, pig-headed person who would not acknowledge that people in the group might have such concerns.
	I want to ask the Minister a couple of questions on this matter. Where in the Bill does it state explicitly that someone in a support group has a right or entitlement to a work-focused interview? I am not asking about the principle of the support group, in which a person will be worked with to realise their potential. It is incredibly unlikely that any Government process, regulation or set of assessment criteria can prejudge the exact state of being of an individual in a support group for a particular period of time. We are all unique. We each have our unique needs, wants, desires and physical and mental attributes, as well as positive and negative outlooks on life. No system could capture every variation of those qualities. There will be a small group of people who might want to take the step away from the support group to try a work-focused interview, and my concern is that the Bill does not state explicitly how they can do that outside of taking the pre-allocated steps set down by the support group.
	My second question relates to clause 11(1)(b). It has been suggested that this provision will somehow close down all the uncertainty about someone voluntarily going for a work-focused interview. I have read the clause about 10 times, and I have scanned the Bill again—I read it 20 or 30 times in Committee—and I do not think that the measure shuts off any of those concerns. The paragraph states that regulations can be made purely for the work-focused interview, but it does not close off all the other avenues in relation to someone who might be successful in their interview but who is still technically a member of the support group. It is not clear from the Bill that other sanctions or regulations would not be applied to them.
	In spite of my slightly agitated remarks today, I very much support the principle behind the Bill. It is a wonderful thing that we are looking at the capacity to work, so why not put these measures into the Bill? Let us open the door so that people can make the choice to have a work-focused interview without worrying that they might be risking triggering a whole new set of regulations.

Jim Murphy: I have pleasure in responding to this very productive and, on most occasions, constructive debate. Opposition Members have spoken from a sedentary position about angry exchanges during our conversation on this group of amendments. However, for the record and for the benefit of the many people who will read our debate, I do not think that anyone would describe this conversation as anything other than reasonable and relatively well informed. When it came to my intervention on the hon. Member for Bury St. Edmunds (Mr. Ruffley), not only did I intervene but, with your permission, Mr. Deputy Speaker, I intervened at some length to enable him to find his reference point in the Bill. That is far from an angry intervention or exchange. That is help and assistance to inform the debate.
	The nearest that we came to an angry exchange was when the hon. Member for Runnymede and Weybridge (Mr. Hammond), again from a sedentary position, chuntered about the resources to enable the fulfilment of the provisions of the Bill. We have said repeatedly that we will fund the national roll-out of pathways using a similar model to the one that already exists across 40 per cent. of the country. It is a bit rich for those who voted against every penny of the money invested to enable that 40 per cent. roll-out of pathways now to say that it is not enough. Their argument at the time of the vote in the House was not that the funding was not enough; it was that they were against every single penny of the investment. That is a matter of public record in  Hansard and in the votes of the House.
	I agreed with the hon. Member for Bury St. Edmunds about our communications. He made an entirely fair point, as have others, about the nature of our communications with our customers, particularly those with a mental health illness or a learning disability. That is why we are finding ways to consult those with mental health illnesses and others about how we can improve our communications with those client groups. When we have an additional set of responsibilities, along with rights, it is important that we get the tone and content of our communications exactly right. The one proviso is that it is difficult to construct a legally based letter in gentle prose in every circumstance, so there will still be aspects of these communications that seem difficult or impenetrable to some people, but that is because it is necessary to set out certain legal responsibilities.
	The hon. Member for Bury St. Edmunds has, throughout these proceedings, shown himself to be well informed, connected to the issues and phenomenally well briefed on the detail that he has brought to his observations in Committee and, thus far, today. Unusually, however, the main burden of his argument on clause 11(1)(b) is based on a misunderstanding of the Bill. There is a power to sanction only those on whom the requirement can be imposed, and because of clause 11(1)(b), that does not apply to members of a support group. There is no power to sanction anyone in the support group. That is explicit in the Bill, and it will be explicit in how the Act operates, and in how advisers and decision-makers, both in the public and private and voluntary sector, operate. I hope that that provides reassurance.
	Let me confirm to the House that, as I said in Committee, someone's well intentioned desire and determination to volunteer would not change their entitlement to be in the support group; only a change in their medical circumstances or condition and a new PCA would do that.

Tim Boswell: That goes to the heart of the concerns that some Members have expressed. Can the Minister give an absolute assurance that the mere fact that someone in the support group has volunteered to participate in a work-focused interview will in no circumstances be treated by the official system as grounds for reopening the case, under clause 9, as to whether such a person should be in the support group?

Jim Murphy: The answer is yes—I do not think that I can be clearer than that.
	The hon. Member for Windsor (Adam Afriyie) asked about our approach. In pathways areas, interviews and support are provided, where appropriate, to customers who volunteer by virtue of section 2 of the Employment and Training Act 1973. The number of interviews is not capped at an arbitrary level. I believe that the approach taken in pathways and in future under the ESA is entirely right. That is the legal basis on which we rest our ability to encourage and support people to volunteer. Thus far, in the roll-out of pathways, that approach has been effective, and it will continue to be appropriate.
	With regard to new clause 7 moved by the hon. Member for Bury St. Edmunds and supported by his hon. Friends, to provide interviews to all members of the support group under any circumstances would be wholly wrong. There will be situations in which that is not appropriate, such as when an interview would be detrimental to the customer's health and safety. I do not want to require staff to conduct interviews in such circumstances. Setting a maximum number of interviews as has been suggested would not be appropriate. It would be wrong for the Bill to impose a legal responsibility to guarantee the right of volunteering for work-focused interviews. In some circumstances, because of the nature of the customer, that could be detrimental to the customer's health, and it would be inappropriate, for health and safety reasons, to ask Jobcentre Plus or private and voluntary sector staff to conduct such interviews. Therefore, the right approach is to allow volunteering under the 1973 Act. It would be wrong, however, to guarantee in the Bill the right of every customer, regardless of their circumstances or health condition, to a work-focused interview.

Jeremy Hunt: Will the Minister confirm that he has just said that if someone in the support group volunteers to take part in a work-focused interview, and the Government decide that it is inappropriate for that person to do so, that person will not be able to volunteer for a work-focused interview?

Jim Murphy: It would not, of course, be the Government, a Minister such as myself or any politician who would take that decision. Medical evidence and advice and the views of personal advisers would determine that it was not appropriate or in the interests of the person concerned to volunteer for such an interview. The example that I used earlier was of someone who had an aneurysm—a point of weakness near the brain. Such a person might say that they wished to volunteer, but the medical advice would be that that was not appropriate at the time, but that help to get treatment, perhaps an operation and other medical support might enable them to volunteer later. That is an entirely sensible and sensitive approach to this progressive policy, and new clause 7 would undermine that.
	Amendment No. 87 refers to the provision of information to those in the support group about their ability to volunteer for work-related activity. I hope that I can provide additional reassurance in that regard. Currently, in pathways to work areas, all new customers, including those exempt from the requirement to take part in interviews, are, where appropriate, provided with a package of information on the support on offer. Furthermore, where appropriate, a personal adviser explains in a telephone call the access to provision in more detail. We are building on that approach through the questionnaire accompanying the invitation to tender for provider-led pathways areas, which specifically asks how the provider will ensure consistent delivery to mandatory and voluntary customers. That is clear in the key criteria set out in documentation to prime contractors, which has been placed in the Library of the House.
	When the employment and support allowance is introduced, we will continue to provide information about opportunities for appropriate voluntary participation to all customers. As always, we need to work to improve those communications, to which I have alluded. Again, we will provide the information to support group customers under the Employment and Training Act 1973. We already use the existing power in that Act to do that for the exempt group in pathways areas.
	In relation to amendment No. 3 tabled by the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), the work-focused health-related assessment is a key element of our aim to provide people with the support that they need to move from dependency on benefits and into work. I acknowledge that the amendment is probing, so I will not be as critical as I would have been were he seeking to divide the House on it. Such an amendment, which would remove the work-focused health-related assessment in its entirety, would morph the refined PCA back into the IB kind of PCA. I accept that a legitimate conversation is to be had about when the work-focused health-related assessment should take place, although not about whether it should take place in principle.
	On the points made by my hon. Friends the hon. Members for Bradford, North (Mr. Rooney), for Kingswood (Roger Berry), and for Blackpool, South (Mr. Marsden), we will pilot the work-focused health-related assessment during 2007, and we have listened to the concerns raised in the debate. As we said in Committee, our preference is for the medical assessment and work-focused health-related assessment to take place on the same visit, as part of a process in which the customer makes one visit. That is convenient for the customer. Again, only having the medical assessment would mimic the worst parts of the current IB PCA. The work-focused health-related assessment focuses on what a person can still do in the world of work and what medical intervention and support is appropriate, which is a much more progressive approach. We have listened to the points made by my hon. Friends, however, and we will reflect further on how we operate that in practice, so that we can support our customers in the most progressive manner.
	The amendment tabled by my hon. Friends the Members for Bradford, North and for Kingswood, which was supported by my hon. Friend the Member for Blackpool, South, would give the customer the opportunity to decide the time and place of the interviews. I think that the amendment refers to giving the right to all customers in all circumstances to decide that, which is not an idea to which we are attracted. We will discuss further, in relation to draft regulations to be provided, how, when a customer's health dictates that it is appropriate, the customer can say, with supporting medical evidence, that their medical condition would make travel to an assessment centre inappropriate, and that they would prefer heath professionals or those carrying out the health assessment and the work-focused health-related assessment to come to their home. In some circumstances, that would be more effective, and we will seek to reflect that in draft regulations. We will be happy to discuss that with my hon. Friends.
	On amendments Nos. 1 and 2 tabled by the hon. Member for Inverness, Nairn, Badenoch and Strathspey and the hon. Member for Yeovil (Mr. Laws), we know that people on benefits can quickly lose their motivation and confidence. We do not want such people to miss out on the work-focused health-related assessment, which is why we are mandating people to take part or face sanctions for failing to do so without good cause. We will ensure that people with mental health problems are not penalised without contact having first been made with them or their carers.
	On sanctions, I wish to confirm the points made by the hon. Member for Inverness, Nairn, Badenoch and Strathspey and disputed by my hon. Friend the Member for North-East Derbyshire (Natascha Engel) about the backdating of sanctions. We will never sanction in the assessment phase. Nor will we reclaim retrospectively money already paid to the customer in the assessment phase.
	I hope that that reassures the hon. Member for Inverness, Nairn, Badenoch and Strathspey. I also hope that my comments have encouraged my hon. Friends not to press their amendments to a vote, and have given some reassurance to Conservative Members supporting new clause 7.
	There is no power to sanction the support group in the Bill, and there will be no such power in the guidance or in operation. We will not seek to impose a sanction on any member of the support group for volunteering to participate in an interview. A changed PCA, not the act of volunteering, would remove someone from the group.

David Ruffley: I agree with one thing that the Minister said: in his opening remarks, he observed that I had been phenomenally well briefed throughout our proceedings. I am less sure that I agree with his other observations.
	I will keep my remarks brief. The fact remains that there has been no misunderstanding among Conservative Members about the purport of new clause 7. For reasons adduced by my hon. Friend the Member for Daventry (Mr. Boswell) and, in a powerful speech, by my hon. Friend the Member for Windsor (Adam Afriyie), it is perfectly clear what the new clause does. It gives comfort and reassurance to members of the support group who wish to do the right thing and volunteer to take part in work-focused interviews leading—we hope—to work-related activity. No such provision appears in the Bill.
	The matter needs clarification. That is what is behind the new clause, and it is in that spirit alone that I wish to press the new clause to a Division.

Question put, That the clause be read a Second time:—
	 The House divided: Ayes 219, Noes 294.

Question accordingly negatived.

Clause 8
	 — 
	Limited capability for work

Roger Berry: I beg to move amendment No. 79, in page 6, line 28, leave out 'medical examination' and insert 'assessment'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments:
	No. 80, in page 6, line 37, leave out 'a medical examination' and insert 'an assessment'.
	No. 81, in clause 9, page 7, line 30, leave out from 'medical examination' and insert 'assessment'.
	No. 82, in page 7, line 38, leave out 'a medical examination' and insert 'an assessment'.
	No. 89, in clause 10, page 8, line 7, leave out 'health-related'.
	No. 90, in page 8, line 12, leave out 'health-related'.
	No. 91, in page 8, line 15, leave out 'health-related'.
	No. 92, in page 8, line 22, leave out 'health-related'.
	No. 93, in page 8, line 44, leave out 'health-related'.
	No. 94, in page 9, line 2, leave out 'health-related'.
	No. 95, in page 9, line 8, leave out 'health-related'.
	No. 96, in page 9, line 11, leave out 'health-related'.
	No. 83, in page 9, line 12, leave out 'health care'.
	No. 72, in page 9, line 16, leave out 'his physical or mental condition' and insert
	'factors that limit his capability to work'.
	No. 84, in page 9, line 20, leave out 'health care'.
	No. 85, in page 9, line 23, at end insert
	'or is concerned with the employment of such individuals'.

Roger Berry: All 16 amendments are in my name and the names of my hon. Friends; that is, I suppose, the parliamentary equivalent of getting a full house. I do not intend to dwell on each of them in detail, but I wish to explain what they have in common and where the differences lie. In essence, the amendments are an attempt to move the Bill, strong though it is, closer to a social model of disability and to make it less obviously focused on issues of medical assessment and health-related matters.
	Let me illustrate my point by discussing the first sub-group. Amendments Nos. 79 to 82 would amend clauses 8 and 9, which concern assessments relating to limited capability for work and limited capability for work-related activity. As the Bill is currently drafted, regulations may make provision for such medical examinations as regulations may require. The purpose of the amendments is to remove the commitment that regulations must be limited to defining capability for work or work-related activity according to a medical examination.
	The point that I am making is similar to that made by the hon. Member for South-West Surrey (Mr. Hunt) in his first contribution to the debate; he did not say that he was articulating the social model of disability, but of course he was. Gone are the days of 12 years ago when finding a Conservative MP who understood the social model of disability was a bit like winning on the pools. Now we are all into the social model of disability, which I welcome. I am being serious, not sarcastic, and I know that the hon. Member for South-West Surrey was not in the House 12 years ago. My serious point is that the whole House seems to have moved towards an understanding that the problems faced by disabled people and those with long-term illnesses in trying to secure employment are not just a medical issue. Medical matters are important, of course, but the whole issue is more important than that.
	The first four amendments are designed to extend the ability of regulations to include other factors and other types of assessment that may not be medically related. Perhaps I can give a simple example. Let us consider someone with a sight impairment. Assessing such a person's capability for work-related activity may matter little as far as a medical examination is concerned. A medical examination may not tell us anything at all that we do not already know; it may be of no value in making a serious assessment of whether such an individual is capable of work-related activity. If one talks about assistive technology for people with sight impairments, one is probably getting closer to the nub of the problem. A whole range of circumstances and other factors—in addition to the specific sight impairment—may affect a person's capability of undertaking work-related activity. I have already referred to assistive technology, but education, skills, training or environmental factors such as access to the workplace may also be relevant, as may other factors within the purview of the employer. Financial support from the Government and whether funding is available for reasonable adjustments are further factors.
	The main point is quite simple: changing the wording in clauses 8 and 9 to include "assessment" rather than "medical examination" leaves open the possibility that regulations can investigate and address the relevant factors. If we do not change the wording, we will close off the possibility of taking into account issues that are, in my view, essential to determining whether people have a limited capability for work or for engaging in work-related activity.

John Robertson: Is my hon. Friend saying that in changing the words from "health assessment" to just "assessment", he means that there has to be an ability for more than one person's assessment of the client or customer to be taken into consideration? Does he mean that a physiotherapist or perhaps a social worker who understands the client's problems should be involved? Is he saying that someone needs to look at the bigger picture rather than take account only of ordinary health matters?

Roger Berry: Yes, indeed; I am saying precisely that. I will come in a few moments to the amendments that deal particularly with assessments. I am concerned that parts of the Bill refer only to assessments by health professionals, because when we consider the factors that restrict people's ability to engage in work-related activity, not only the health professional's assessment matters. It is the assessment of professionals who understand the workplace that matters.

Michael Weir: I very much agree with the hon. Gentleman and his amendments seem sensible, but given that his examples relate to new technology or perhaps involve adaptations to the workplace, considerable costs may be incurred. We have already heard concerns about funding the roll-out of pathways to work, so has he made any investigations into the potential cost of the changes that he wants?

Roger Berry: The hon. Gentleman will know that I have raised the issue of resourcing this programme both in the Chamber and elsewhere, and I am sure that discussions between the Minister and the Treasury are ongoing. Clearly, the important point is that the more people are empowered to go back to work, the more the Exchequer saves a substantial sum of money: the recycling possibilities are enormous.
	Let me move on briefly to amendment No. 89 and amendments Nos. 90 to 96, which relate to the work-focused health-related assessments. They are designed essentially to remove reference to "work-focused health-related assessments" and to replace that phrase simply with "work-focused assessments" for precisely the reason that I do not see why we cannot talk about work-focused assessments in the round. I have already made the point, but let me provide another example.
	Someone who has been a wheelchair user from childhood or, like one of my constituents, is a wheelchair user as a result of an accident, may subsequently be far healthier than someone who is not disabled. The problem is not the health assessment of a wheelchair user, but assessing that person's capacity to engage in work-related activity and, ultimately, to work. That can have a lot to do with access to the workplace, as the building may require ramps, lifts and so forth.
	I genuinely do not understand why, when we are talking about work-focused assessments, which are crucial to the Government's strategy, we have to tag on the "health-related" provision. Someone somewhere, it seems to me, has a bit of the old medical model in the system and I am urging whoever it is to relax a little and look more broadly at the obstacles that people face, because they are not always entirely health-related.
	Amendments Nos. 83 to 85 are designed to amend clause 10. As drafted, subsection (7) states that
	"'work-focused health-related assessment' means an assessment by a health care professional"—
	a point that has been made already. I reiterate that work-focused assessments should not be restricted to health matters, so those who make the assessments should not be restricted to health professionals: that follows as night follows day.
	Time is limited, so I shall move quickly to amendment No. 72, which also relates to clause 10. Subsection(7)(c) refers to assessing
	"such other matters relating to his"
	or her "physical or mental condition". Again, instead of referring to matters confined to that condition, why do we not make provision for factors that limit people's "capability to work"?
	In summary, all 16 of my amendments are designed to recognise that capability for work or work-related activity is not solely a health matter and cannot be solved only by medical or health professionals. The Government obviously subscribe to the social model of disability—hence the whole package of measures introduced over the past 10 years that have been all about empowering disabled people to remove the barriers that they face in work and elsewhere. That is what motivates the strategy. Clearly, the Opposition—and I mean both parties—subscribe to the social model of disability, so I feel sure that they will strongly support the sentiments that I have expressed.
	To conclude, the danger of not seeking to deal with the concerns that I have expressed through the amendments is that the Government will deny themselves the possibility of framing regulations that adopt a broader approach to meeting individual need. If they are not careful, they will be less successful in achieving the objectives that we all share.

Jeremy Hunt: It is a pleasure and privilege to follow the hon. Member for Kingswood (Roger Berry), who is extremely well known for his commitment to dealing with disability issues. I am sorry that listening to one of my speeches is no longer like winning the pools, as it might have been 12 years ago. I believe that there is indeed considerable understanding of the social model of disability in the Conservative party.
	As the hon. Gentleman rightly said, his amendments are intended to promote the social as opposed to the medical model of disability. Some hon. Members might be tempted to think that this is all a matter of semantics, but if they did, they would be greatly mistaken. The social model is essentially a recognition that, if we are to move towards including disabled people in the mainstream of society, we have to move beyond seeing disability as a purely medical condition. We must also accept the importance of removing the barriers faced by disabled people in society at large—whether they be practical barriers, such as problems with physical access to buildings or public transport, or psychological barriers caused by the attitudes and prejudices of others.
	One of the disappointments of the Bill is that it says nothing about the responsibilities of the wider community to help disabled people achieve engagement in the world of work. There is plenty of talk about what might be called the supply side of the problem—that is, about getting people ready for work—but very little about the demand side of ensuring that opportunities are not stifled by outdated or prejudiced attitudes among employers or society at large. That is where the social model is very important.
	In Committee, we had substantial discussions about the appropriate use of language. A number of amendments suggested using the phrase "labour market disadvantage" instead of "limited capability for work" at the beginning of the process. The Minister rejected that option, and he may be tempted to use the same arguments again today, but today's amendments are nothing like as strong, as they would simply replace the words "medical examination" with the word "assessment". Omitting the word "medical" would not mean that no medical examination would take place, but it would make it possible for the medical examination currently planned to be expanded to cover a wider remit, as and when the Government consider that to be appropriate. The Minister may argue, as he did in Committee, that it is vital that the tests be objective. My response is that that objectivity is not confined to medical tests: when a person faces a barrier to employment that is linked to a disability, can that not also be looked at objectively?
	Conservative Members accept that an objective assessment of a person's impairment must be the starting point. That means, at a bare minimum, that the phrase "medical examination" in clauses 8 and 9 should be changed to "health and disability examination". The phrase "medical examination" strongly suggests an examination of a person's health, but it is clear from the PCA, the regulations and the 48 descriptors used to assess a person's limited capability for work-related activity that the medical examination will look at issues to do with that person's health and disability.
	The amendments would remove the language problem. Removing the word "medical" and calling the process an "assessment" would allow the process to be defined much more broadly. It would also allow it to be defined nationally and consistently. The Minister made clear in Committee his legitimate concern that widening the assessment to take account of other, non-health related factors would be unworkable in practice, but I repeat that the amendments would not commit the Government to widening the scope of the assessment in a specific way that would make it unworkable. They would merely change the language used to allow for a possible widening of the scope of the assessment at a later stage.
	If the Government accepted the proposals, they would be signalling that they really understand that achieving the Bill's objectives involves tackling the wider barriers that disabled people face, as well their individual impairments. Therefore, I hope that the Government will give the amendments careful consideration.

Danny Alexander: I shall be very brief, as I know that the Minister wants to respond to the debate. The amendments so eloquently explained by the hon. Member for Kingswood (Roger Berry) touch the conceptual basis of the Bill, and are profoundly important. He was right to say that all parties subscribe, to a greater or lesser degree, to the social model of disability. They agree that a disability is not merely a health condition or impairment, but has to do with the barriers that society puts in the way of people who are disabled. It is important that the Bill reflect that conceptual agreement, and the amendments draw attention to the language that is used in the Bill.
	The hon. Member for South-West Surrey (Mr. Hunt) said that we debated amendments in Committee that would have used the term "labour market disadvantage" in relation to disability or impairment. I believe that that would capture much more accurately what the assessment procedure would determine, and today's amendments would allow the same thing to happen. They would not in every case lead to huge changes in how the assessment process works—although they might do so in respect of the work-focused health-related assessment—but they would send the clear signal that the Bill makes real the Government's acceptance of the reality of the social model of disability. For that reason, I commend the amendments to the House.

Charles Walker: I am sorry that I was not present for the whole debate, but I congratulate the hon. Member for Kingswood (Roger Berry) on these amendments.
	I believe that the vast majority of people not currently in the labour force want to work. I have been a Member of Parliament for 18 months, and most of the people with disabilities whom I have met in that time have been desperate to re-enter the work force. I understand the arguments underpinning the amendments—that the words "medical assessment" attach a pejorative meaning to a condition that many people have come to terms with.
	People with serious disabilities try to overcome them, and very often succeed—to the extent that when one meets them on the street and asks how they are they respond by saying that they are feeling extremely well. They say that because they have moved on from their disability, and that is why the hon. Member for Kingswood is right to say that the word "assessment" is much to be preferred.
	With this Bill, we are trying to help people re-enter the labour market. We are not burdening them with a medical condition, but are trying to find a route that eases them back into work. We are also trying to put in place the support systems that allow them to re-enter the labour force with the mechanisms that they need to be productive and have successful and fulfilling careers.
	Many of the people whom I have met feel excluded from the labour market because they believe that there is a lack of understanding of, or concern about, what they need to make the transition back into work. I know that my party supports these amendments, so my support for them will not upset anyone. People with disabilities face the stigma that they have a medical condition. If the amendments get rid of that, that is another excellent reason to support them.

Jim Murphy: I am pleased to have the opportunity to respond briefly to this important debate on the 16 amendments tabled by my hon. Friends the Members for Kingswood (Roger Berry), for Bradford, North (Mr. Rooney) and for Hayes and Harlington (John McDonnell).
	My hon. Friend the Member for Kingswood was right to say that the Government have taken the social model approach to civil rights and the rights of people who are disabled, in relation to the labour market but in other aspects of public policy too. The Disability Discrimination Act 1995 was followed by the establishment of the Disability Rights Commission and other strengthening of disabled people's civil rights. Although these amendments differ from the proposals discussed in Committee, for technical reasons I cannot accept them. If I have time, I shall explain why the wording used prevents that, but I assure my hon. Friend that I am happy to expand on the specifics in the regulations that are put forward.
	In the minute and a half that I have left, I want to assure the House that the work-focused health-related assessment and the medical examination process will not look only at medical issues. Non-medical barriers will not be ignored; they will also be taken into account in the draft regulations based on these clauses that we will table for consideration. They will be specific and detailed in their approach, and will examine more than just the medical barriers faced by people with disabilities who want to re-enter the labour market.
	The reason why we are using the phrase "medical examination" is that the word "assessment" is a catch-all that captures all three parts of the process—gathering the evidence is part of an assessment; the medical examination is part of an assessment; and the work-focused health-related assessment is also part of a wider assessment. In clause 8 and in regulations we use the word "assessment" to relate to the whole process.
	Although I accept the way in which my hon. Friend has tabled his amendments, technically we think that they are confusing.
	 It being Eight o'clock, Mr. Deputy Speaker  put forthwith the Question already proposed from the Chair, pursuant to Order [this day].

Roger Berry: rose—

Mr. Deputy Speaker: Order. It is too late for the hon. Gentleman to withdraw his amendment. The question has to be put.

Roger Berry: I was just about to withdraw the amendment.

Mr. Deputy Speaker: I apologise to the hon. Gentleman; he was not called during the time allotted by the programme motion, so I must now put the question. If the House so wishes, it can be negatived.
	 Amendment negatived.
	Mr. Deputy Speaker  then proceeded to put forthwith the Questions necessary for the disposal of the business to be concluded at that hour.

Clause 14
	 — 
	Directions about work-related activity

Amendment made: No. 7, in page 12, line 33, leave out subsection (4).— [Mr. Heppell.]

Clause 15
	 — 
	Contracting out

Amendments made: No. 8, in page 13, line 4, leave out from 'function' to 'regulations' in line 5 and insert 'under'.
	No. 9, in page 13, line 6, leave out paragraph (b).
	No. 10, in page 14, line 6, at end insert—
	'( ) Any decision which a person authorised to exercise any function by virtue of subsection (1), or by virtue of regulations under subsection (2), makes in exercise of the function shall have effect as a decision of the Secretary of State under section 8 of the Social Security Act 1998 (c. 14).'.
	No. 11, in page 14, line 17, at end insert—
	'( ) In this section, references to functions of the Secretary of State under—
	(a) an enactment contained in, or in regulations under, this Part, or
	(b) an enactment contained in Chapter 2 of Part 1 of the Social Security Act 1998 (c. 14),
	include a reference to any function which the Secretary of State has by virtue of the application in relation to that enactment of section 8(1)(c) of that Act (decisions under certain enactments to be made by the Secretary of State).'.— [Mr. Heppell.]

Clause 66
	 — 
	Transition

Amendments made: No. 13, in page 48, line 3, after 'Act' insert ', except Part 1,'.
	No. 14, in page 48, line 8, leave out subsection (3).— [Mr. Heppell.]

Clause 67
	 — 
	Extent

Amendments made: No. 15, in page 48, line 22, leave out '10(28)' and insert '10(1) and (28)'.
	No. 16, in page 48, line 22, after '18' insert
	', 22(1) to (1B), (4) and (5)'. —[Mr. Heppell.]

Schedule 1
	 — 
	Employment and support allowance: additional conditions

Amendment made: No. 17, in page 51, line 43, leave out '(g)' and insert '(f)'.— [Mr. Heppell.]

Schedule 2
	 — 
	Employment and support allowance: supplementary provisions

Amendment made: No. 18, in page 55, line 37, at end insert—
	'(aa) for the question of whether a person has limited capability for work-related activity to be determined notwithstanding that he is for the time being treated by virtue of regulations under sub-paragraph (a) as having limited capability for work-related activity;'.— [Mr. Heppell.]

Schedule 3
	 — 
	Consequential amendments relating to Part 1

Amendments made: No. 19, in page 66, line 42, leave out 'income-related'.
	No. 20, in page 67, line 2, leave out 'income-related' and insert 'an'.
	No. 21, in page 67, line 4, at end insert—
	'( ) in that paragraph, in sub-paragraph (1)(d), after "state pension credit" insert ", deductions from an employment and support allowance".'.
	No. 22, in page 67, line 5, leave out paragraph (c).
	No. 23, in page 67, line 13, leave out 'income-related'.
	No. 24, in page 67, line 15, leave out paragraph (b).
	No. 25, in page 68, line 10, at end insert—
	'Pensions Act 1995 (c. 26)
	In Schedule 4 to the Pensions Act 1995 (equalisation of pensionable ages for men and women), in paragraph 1 (enactments for the purposes of which the rules for determining pensionable age apply) for "and the State Pension Credit Act 2002" substitute ", the State Pension Credit Act 2002 and Part 1 of the Welfare Reform Act 2007".'.
	No. 26, in page 69, line 39, at end insert—
	'() In section 31 (incapacity for work), after subsection (1) insert—
	"(1A) Regulations may provide that a determination that a person is disqualified for any period in accordance with regulations under section 17(1) to (3) of the Welfare Reform Act 2007 shall have effect for such purposes as may be prescribed as a determination that he is to be treated as not having limited capability for work for that period, and vice versa."'.
	No. 27, in page 71, line 7, leave out sub-paragraph (1) and insert—
	'(1) The Social Security Fraud Act 2001 is amended as follows.
	(1A) In section 7 (loss of benefit for commission of benefit offences) after subsection (4A) insert—
	"(4B) The Secretary of State may by regulations provide that, where the sanctionable benefit is employment and support allowance, any income-related allowance shall be payable, during the whole or a part of any period comprised in the disqualification period, as if one or more of the following applied—
	(a) the rate of the allowance were such reduced rate as may be prescribed;
	(b) the allowance were payable only if there is compliance by the offender with such obligations with respect to the provision of information as may be imposed by the regulations;
	(c) the allowance were payable only if the circumstances are otherwise such as may be prescribed."
	(1B) In that section, in subsection (8) (interpretation), in the definition of "disqualifying benefit", after paragraph (aa) insert—
	"(ab) any benefit under Part 1 of the Welfare Reform Act 2007 (employment and support allowance) or under any provision having effect in Northern Ireland corresponding to that Part;".'.
	No. 28, in page 71, line 9, after 'In' insert
	'section 9 (effect of offences on benefits of members of offender's family), in'.
	No. 29, in page 71, line 12, at beginning insert 'In that section,'.
	No. 30, in page 71, line 26, at end insert—
	'(4) In section 10 (power to supplement and mitigate loss of benefit provisions), in subsection (3) (definition of "social security benefit"), after paragraph (bb) insert—
	"(bc) any benefit under Part 1 of the Welfare Reform Act 2007 (employment and support allowance) or under any provision having effect in Northern Ireland corresponding to that Part;".
	(5) In section 13 (interpretation of sections 7 to 12), after the definitions by reference to the Jobseekers Act 1995 insert—
	""income-related allowance" has the same meaning as in Part 1 of the Welfare Reform Act 2007 (employment and support allowance);".'.— [Mr. Heppell.]

Schedule 4
	 — 
	Transition relating to part 1

Amendments made: No. 31, in page 72, line 13, at end insert—
	'General power to provide for transition relating to Part 1
	(1) Regulations may make such provision as the Secretary of State considers necessary or expedient—
	(a) in connection with the coming into force of any provision of, or repeal relating to, this Part, or
	(b) otherwise for the purposes of, or in connection with, the transition to employment and support allowance.
	(2) The following provisions of this Schedule are not to be taken as prejudicing the generality of sub-paragraph (1).'.
	No. 32, in page 73, line 1, after 'allowance' insert
	'of such a kind as the regulations may provide'.
	No. 33, in page 74, line 30, after '30A' insert ', 40 or 41'.
	No. 34, in page 74, line 31, at end insert—
	'( ) an award of long-term incapacity benefit under regulation 11(4) of the Social Security (Incapacity Benefit) (Transitional) Regulations 1995 (S.I. 1995/310) (former sickness benefit);'.
	No. 35, in page 74, line 32, leave out from second 'of' to 'as' in line 34 and insert 'those regulations'.
	No. 36, in page 74, line 39, after first 'of' insert—
	'(i) '.
	No. 37, in page 74, line 39, after '(b)' insert ', 8, 10, 12 or 13'.
	No. 38, in page 74, line 41, after 'work' insert 'or disability'.
	No. 39, in page 74, line 41, at end insert ', or
	(ii) regulation 13(2)(b) or (bb) of, and paragraph 15 of Schedule 1B to, those regulations (income support for disabled persons in education).'.
	No. 40, in page 75, line 5, after 'Part' insert
	', or any other enactment relating to social security,'.
	No. 41, in page 75, line 9, at end insert—
	'( ) In this paragraph "enactment" includes an enactment contained in subordinate legislation (within the meaning of the Interpretation Act 1978 (c. 30)).'.
	No. 42, in page 75, line 30, after '30A' insert ', 40 or 41'.
	No. 43, in page 75, line 34, at end insert—
	'(i) '.
	No. 44, in page 75, line 35, after '(b)' insert ', 8, 10, 12 or 13'.
	No. 45, in page 75, line 36, at end insert ', or
	(ii) regulation 13(2)(b) or (bb) of, and paragraph 15 of Schedule 1B to, those regulations.'. — [Mr. Heppell.]

Schedule 8
	 — 
	Repeals

Amendments made: No. 46, in page 82, leave out line 46.
	No. 47, in page 84, line 21, at end insert—
	'Section 31(1).'.
	 —[Mr. Heppell.]

Clause 29
	 — 
	Local housing allowance

Andrew Love: I beg to move amendment No. 48, in page 20, line 16, at end insert—
	'( ) The AMHB shall vary only for those aged under 21.'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments:
	No. 5, in page 20, line 33, at end insert—
	'( ) The Appropriate Maximum Housing Benefit may not vary according to the age of the claimant.'.
	No. 67, in page 22, line 9, clause 30, leave out 'five years' and insert 'twelve months'.
	Government amendment No. 12
	No. 70, in page 29, line 39, clause 35, at end insert—
	'(4) In respect of determining the local housing allowance, the rent officer upon request, shall make available within a reasonable period the evidence and data used to calculate the local housing allowance.
	(5) In determining the broad rental market area or areas in relation to a local authority, the rent officer, upon request, shall make available within a reasonable period the evidence and data used to determine the broad rental market area or areas.
	(6) In determining the broad rental market area or areas, the rent officer shall consult with the relevant local authority or authorities on the boundaries and extent of that area or areas.
	(7) Consultation undertaken under subsection (6) shall be in accordance with such requirements as may be specified in regulations made by the Secretary of State.
	(8) In this section "broad rental market area" means an area—
	(a) comprising two or more distinct areas of residential accommodation, each distinct area of residential accommodation adjoining at least one other in the area;
	(b) within which a person could reasonably be expected to live having regard to facilities and services for the purposes of health, education, recreation, personal banking and shopping, taking account of the distance of travel, by public and private transport, to and from facilities and services of the same type and similar standard; and
	(c) containing residential premises of a variety of types, and including such premises held on a variety of tenancies.'.

Andrew Love: The amendment would end the shared room rate at the age of 21 rather than at 25, as at present. It is a compromise that we hope reflects the debate held in Committee, which I read with great interest.
	I tabled the amendment for several reasons. It maintains the shared room rate principle that seems so important to the Government, but for a more restricted age range. Twenty-one better reflects the age of maturity, or majority. When I was a kid, the saying was that at 21, we got the key of the door. The amendment attempts to reflect that reality.
	More seriously, by the time most young people reach 21, they have had a period of training and many will have had significant periods of employment. They will have made a contribution to society and that should be reflected in the way we treat them in the benefits system by the provision of full housing benefit. That would help them to achieve independence and the stable accommodation necessary for them to fulfil their life's ambition.
	A number of issues in the Committee debate were of great interest to me. The first was the supply of shared accommodation, a subject that took up much time during the debate, which surprised me. Several Members talked about the recommendation in the Barker housing review for a much larger supply of social rented accommodation, as well as the need to increase the overall building of houses and the impact of buy-to-let on the provision of additional accommodation in the private rented sector. Some of those things are being achieved, but no one, either in the Committee debates or Ministers in other debates or in answer to questions, has suggested any specific plans to increase the amount of shared accommodation that will be necessary for young people if the single room rate is maintained. That is important as it is widely recognised that there is scarcity in some parts of the country; indeed, shared accommodation is almost non-existent in many areas.
	I welcome the previous extension of the definitions of single room rent and shared room rate and the further changes proposed in the Bill, but part of the reason for widening those definitions was the hope of increasing supply of that type of accommodation. However, research conducted after the first widening in 2001 showed clearly that it had no impact on young people's ability to access accommodation. Similarly, research on the pathfinders project found no appreciable difference in either the supply or quality of accommodation, so the changes did not help.
	There have been negative features. It is becoming increasingly clear that many landlords are reluctant to rent to people on housing benefit, which particularly applies to young people and to those on the more restricted shared room rate suggested in the Bill. Not only is their housing benefit restricted but their jobseeker's allowance and income support is paid at a lower rate, which makes them an even less attractive proposition to landlords.
	It has been noted that there has been a decline in the number of houses in multiple occupation. It is clear that whatever the reasons are—I am sure they are complex—the number of units of shared accommodation offered by landlords in the future is likely to continue to decline. Neither the Bill nor outside factors are doing anything to increase the supply of such accommodation. Indeed, the solutions are long term, as Barker proposed, but if we are to address the problems faced by young people we need shorter-term solutions.

Lynne Jones: In some areas there has been a substantial increase in the availability of HMO accommodation, but it is generally in areas surrounding universities, where there is demand from students and much money to be made by buy-to-let landlords. However, those landlords are not at all interested in letting to young people who need housing benefit, or a contribution from housing benefit, to afford their rents.

Andrew Love: My hon. Friend is undoubtedly correct. For those and other reasons, landlords are increasingly reluctant, in whatever part of the private rented sector, to consider people on housing benefit, which particularly affects young people.
	Costs were not much discussed in Committee, but they are important. Any estimate of the cost of the amendment would vary according to the assumptions written into it. If behavioural factors are not taken into account, the DWP estimates the cost of the proposal at about £20 million. On that basis, we can assume that my amendment would cost about half that—about £10 million; but to be sure, let us say £12 million, as there may be more people at the top rather than the bottom of the system.
	When behavioural factors are considered, we have to go back to before the restriction was introduced. The number of people in such accommodation is 12,000 at present but was about 32,000 in 1996, before the introduction of the restrictions, so when we add in behavioural factors we reach a figure of £30 million. During the debates in Committee I was interested to hear the Minister suggest that part of the reason the number of people in single room rent accommodation had gone down was the fact that many more of them were in employment. If we take that into account, the figure is likely to be smaller. None the less, whichever way we work out the figure, my amendment is unlikely to cost any more than £30 million or, if we take behavioural factors into account, £40 million or £50 million. To put that into context, about 800,000 people who live in the private rented sector are in receipt of some form of housing benefit and the overall housing benefit bill is about £12 billion. This is a modest amendment.
	Much discussion took place about tenant empowerment. When the restriction was introduced, it was suggested that tenants should negotiate with landlords, but the research carried out in 2001 blew out of the water the idea that that was a practical reality. The latest proposals suggest that tenants in whatever part of the housing benefit regime should be able to shop around because they will know in advance what their housing benefit is likely to be. The evidence from the pathfinders does not offer a great deal of support for that proposition. Although there has been a welcome and recognised fall of about £3 in the gap between the rent that tenants pay and the benefit that they receive, the percentage of those under 25 who are affected by a shortfall has stubbornly been maintained at 70 per cent.

David Lepper: On the point that my hon. Friend has just made about tenants shopping around and the experience of the pathfinders, it might help him to learn that I spoke this afternoon to Julia Harrison, the housing manager for Hove YMCA, which manages housing for young people in the city of Brighton and Hove. She tells me that one of the consequences of the single room rent is that young people are forced into inappropriate shared accommodation often with no proper tenancy contract at all. That makes them increasingly vulnerable. They have certainly not been empowered.

Andrew Love: I thank my hon. Friend for that intervention. I agree entirely. Where there is a lack of supply and the shortfall is so significant, it is likely that all the power will be in the hands of the landlord rather than in the hands of the tenants, who will be forced into situations not of their choosing.

Madeleine Moon: In a similar vein, I have been talking to local housing providers—Llammau and Hafod's Yellow project—and to my local authority and the assistant director responsible for housing. Along with the Welsh Assembly Government, they have called for the abolition of the single room rent. The person to whom I spoke from Llammau made the point that the best outcome that young people can currently hope for is debt. The worst outcome is eviction, harassment, repossession and severe debt. A Labour Government cannot allow that to continue. Does my hon. Friend agree that we need to give these particularly vulnerable young, who do not live in the idyllic world of "Friends" and do not share a luxury apartment, the opportunity to move forward?

Andrew Love: I agree entirely. I was about to come to the wider Government objectives that will be achieved by the Bill, but I did not want to comment particularly on poverty, homelessness and social exclusion. My hon. Friend has done so on my behalf, so I shall focus my brief remarks on incentives to work and on the disincentive that the proponents of this restriction suggest occurs. They suggest that if the restriction did not exist, those on housing benefit would have an incentive to stay out of work because they would get better accommodation than they would have if they were in low paid employment. However, that view fails to recognise reality in a number of respects.
	First, the restriction affects those in work and, in particular, those in low paid work who will receive the shared room rate as part of their housing benefit. Secondly, the restriction has not been effective. The research shows clearly that it has not been effective in encouraging claimants to enter shared accommodation. The proportion of young people in shared accommodation has declined since its introduction. The shortfalls in the shared room rate concept exacerbate hardship for young people, including those who are employed and facing enormous difficulties in sustaining employment. The restriction has created a whole generation of what we term the "hidden homeless"—young people living on the sofas of friends and relatives. The lack of stable accommodation will threaten the employment and the employment prospects of the young people concerned, and the evidence shows that quite clearly. A whole series of negative consequences have occurred because of the introduction of the restriction.
	My amendment would do a number of things. First, it would maintain the principle enshrined in the shared room rate that the Government feel is important in the new housing benefit regime. It would also allow those who have reached the age of maturity—the amendment sets that at 21—to obtain the more settled accommodation that I hope would provide them with the springboard for better employment prospects and to realise their ambitions. That is what the Government say is their overwhelming objective for young people. The amendment would achieve the objectives that the Government have set, and I commend it to the House.

Danny Alexander: It is a pleasure to follow the hon. Member for Edmonton (Mr. Love), who has rightly stated the strong case in principle for the change that he proposes. In Committee, I moved an amendment similar to amendment No. 5, which is on the amendment paper today. It goes a little further than his amendment in that it proposes the abolition of the shared room rate altogether. I do not know yet whether he intends to press his amendment to a Division. If he does not, may I indicate at this stage, Madam Deputy Speaker, that I intend to divide on amendment No. 5, if that is in order?
	The hon. Gentleman and the hon. Member for Bridgend (Mrs. Moon) have shown a degree of consistency with their party's position. When the single room rent was introduced in 1996, it was opposed fully by the then Labour Opposition. The Prime Minister, the Chancellor of the Exchequer, the Deputy Prime Minister and the Secretary of State for Work and Pensions all went through the Division Lobby to vote against the introduction of the single room rent. They were right to do so and we would be right either to ameliorate the impact of the single room rent on young people or to get rid of it altogether. The statistics that some of the lobbying groups have presented show that 87 per cent. of all claimants who are currently in receipt of the shared room rate face a shortfall between what they receive in housing benefits and what they pay in rent. That shortfall averages out at £35.14 a week.
	As the hon. Gentleman rightly said, there is a shortage of accommodation that satisfactorily meets the SRR available to under-25s. The point was made about YMCAs. Charities working with young homeless people report that they are often unable to move those young people on to appropriate accommodation after they have, for example, spent time in a hostel. That is because of the impact on affordability of the shared room rate for young people who seek to move on from those circumstances and to take responsibility. Taking responsibility is part of the principle that the Government seek to develop behind the local housing allowance. However, the current system of a shared room rate militates against young people taking responsibility for themselves, finding their own accommodation and getting the support that they need to do so. The shared room rate can be a real disincentive for young people when it comes to leaving supported accommodation, because they know that they will face a shortfall. Indeed, the YMCA reports that 35 per cent. of young people in YMCA accommodation are ready to move on, but are unable to find anything that they can possibly afford to rent.
	Affordability is not the only barrier. As the hon. Gentleman rightly said, there is substantial evidence that landlords are more unwilling to let to under-25s who are on benefits. With his amendment, that unwillingness would at least be reduced, but it would still apply to under-21s. According to Shelter, although 46 per cent. of one-bedroom properties were affordable to those entitled to the one-bedroom rate—in other words, over-25s entitled to the one-bedroom rate—only 26 per cent. of the properties matching the shared room rate definition were available at or below the shared room rate. I can give a local example that may help to illustrate that. In Sutherland and Easter Ross in the Highlands, the shared room rate is set at £35 a week. I know that to Members who represent urban constituencies that might seem very low. In that part of the world, only one landlord provides accommodation matching the shared room rate definition—£95 a week. Any young person under 25 in that part of the world, on benefits and looking to rent accommodation, faces a shortfall of £60 a week.
	Since we debated the matter in Committee—I know that the Minister made her response then—there has been further evidence from the Department for Work and Pensions that helps to support the case that is being made in the amendments. Recent evidence indicates that landlords are becoming increasingly reluctant to let properties as houses in multiple occupancy and that they are reluctant to let at all to housing benefit—or local housing allowance, as it will be—claimants. There is often—this comes through from, for example, research that Shelter has been doing—increased competition for rooms in shared accommodation. That competition comes not only from students and professionals, as was mentioned in an intervention, but from migrant workers. That is a relevant point for consideration in terms of the effect on rents and supply. That phenomenon has been reported by Shelter.
	The pressure and the competition faced by young people who are entitled to only the shared room rate is getting worse, not better. That competitive pressure will mean that the shortfalls that those young people face will become more dramatic and the consequences of those shortfalls for those young people, in terms of debt, hardship, eviction and having to go into supported accommodation, will all become more severe.
	In a sense, I will close on the same point as the hon. Gentleman closed on. He quite rightly referred to incentives to work. Incentives to work are really the whole thrust of a large part of the Bill. However, this is one area where, for some reason, the Government seem unwilling to embrace a suggestion that, as he said, could be delivered relatively cheaply. I did not necessarily like the way in which the figure got inflated in a matter of seconds. None the less, in the context of the overall Bill, the proposal is relatively cheap. Even complete abolition of the single room rent has been costed at £20 million, in ministerial answers. Even taking into account behavioural consequences, the cost would still be relatively low. However, the impact on work incentives for young people can often be dramatic.
	Those of us who attended a briefing session held on the issue by Shelter, the YMCA and other organisations involved in the coalition campaigning against the situation, heard directly from some young people who had been living in supported accommodation about the impact that the situation can have on their ability to find a job. Earlier, we discussed the importance of the fact that many of the people we are talking about want to work and just need assistance to do so. For no group is that more true than the young people addressed by amendment No. 48. However, the problems of having no fixed address, building up debt problems and being unable to afford rent all represent substantial disincentives to work. If for no other reason than to address that situation, which would be consistent with the Government's thinking on welfare reform, I urge the Minister to reconsider the position that she took in Committee and to endorse amendment No. 48.

Terry Rooney: I wish to speak to amendments Nos. 70 and 67, which I tabled.
	Amendment No. 70 relates to rent officers. Many people might be totally unfamiliar with them. They are peculiar figures in our society who have enormous power and can influence an incredible number of people's lives, yet, sadly, they are subject to little accountability or scrutiny and there is little transparency in their work. At the moment, under the housing benefit system, a rent officer decides what localities will be used to measure rents for different types and sizes of property. He then sets the local reference rent, which is effectively the maximum amount of housing benefit that one can get in an area. Under the local housing allowance scheme, he will set the broad rental market area, which is the area in which different types of property are situated, and set its local housing allowance rate, which, again, will be the maximum amount that claimants can get.
	A rent officer does that without reference to anyone and without consulting anyone. The decisions appear to be unchallengeable and are not subject to any scrutiny or serious investigation. A rent officer is not even required to consult the relevant local authority, which is strange when one considers that even those local authorities that are no longer landlords still have a strategic housing duty and a duty to homeless people. Guidance on homelessness from the Department for Communities and Local Government instructs local authorities that they should have regard to the private rented sector, yet local authorities have no input into a rent officer's assessment of those rental rates.

David Taylor: Is it not also the case that a rent officer does not have to explain, justify or provide evidence to support a calculation that he or she has to undertake? A couple in my constituency assembled a dossier of all the rental accommodation in a certain category that had been advertised over quite a long period, and none had been available at the rent that the officer had suggested.

Terry Rooney: Sadly, my hon. Friend's experience is all too common in all too many parts of the country. I understand that there are some good rent officers. I have yet to find one, but I am told that they do exist.
	The simple fact of the matter is that this system affects millions of people's lives. It affects the amount of housing benefit or local housing allowance that people can get. Rent officers operate under a regime of secrecy, unaccountability and serious inconsistency, as my hon. Friend said, and there can be no challenge to the decisions at which they arrive. Amendment No. 70 would bring transparency to the system. It would require a rent officer to publish the data and evidence on which his calculations were based. It would also allow the Secretary of State to make directions about how that evidence should be collected, assessed and used. In this day and age, to have a public official with such incredible powers, yet subject to no public scrutiny at all, is just plain wrong. I accept that the amendment might not be perfectly worded, although I think that it is pretty good, and I look forward to hearing the comments of my hon. Friend the Minister.
	Amendment No. 67 addresses the antisocial behaviour aspects of the Bill that relate to sanctions on housing benefit. I have to say first—I have made this point several times in the past and although no one has listened, I hope to carry the day—that it is plain wrong and a massive injustice that there is a sanctions regime that applies to only one type of tenure in the housing market. As everybody knows, on virtually every housing estate in the country, two thirds of the old local authority stock has been sold. If two neighbours are found guilty of the same antisocial behaviour, but one is an owner-occupier, and the other is a tenant, the tenant could lose his home and 100 per cent. of his housing benefit for up to five years, but there would be no sanction whatever against the owner-occupier, and that is not right.
	I accept that the proposals in the Bill are to be piloted—God help the 10 pilot areas—but a serious rethink of the principles underlying the measure is needed. I utterly opposed the proposals in 2003, and the Government saw sense and withdrew them. I accept that the proposals have been revised and refined, but they are still simply wrong. I remind hon. Members that if a person's behaviour does not change in the first four weeks after the original possession order, there is a 10 per cent. reduction in housing benefit. Between five and eight weeks after the order, there is a 20 per cent. reduction, and after that, for up to five years, there is a 100 per cent. reduction. The person gets nothing. Of course, if the housing benefit officer thinks that that will cause hardship, the 100 per cent. rate can be reduced, but it is evident that it will cause hardship. If someone is on income support and is entitled to 100 per cent. housing benefit, but instead they get nothing, they will obviously be in hardship.
	That is not to undermine in any way the serious implications of antisocial behaviour. We have all seen, experienced, and had to deal with it, and most of us welcome the legislative action that the Government have taken. However, let us be fair: there is a personal responsibility on the individual who causes the antisocial behaviour, whether they be a householder, a parent, or an older teenager, but there is a responsibility on the state, too. If we reach the stage at which a family has been evicted for antisocial behaviour, the mechanisms that we have put in place, and the state, have failed in dealing with the family and its problems; we need to recognise that. The 100 per cent. reduction in housing benefit for five years is an abuse of human rights. The amendment, which possibly does not go far enough, would limit the 100 per cent. reduction to 12 months. I hope that we will hear co-operative words from the Minister on that amendment.
	I now turn to the amendment on the single room rate, which was so ably moved by my hon. Friend the Member for Edmonton (Mr. Love). I understand, but I do not agree with, the philosophy behind the single room rate, which is that it is not right that someone can leave school at 18 and go straight on to benefits and enjoy a lifestyle that is not available to people who are in a similar situation, but are in work. However, the reality is that most people to whom the single room rate or the shared room rate applies are not in that category. Most of them have, at some time, been in care. I know that people under 21 are excluded if they have been in care, but when they are 21 and one day, the regime applies. All the evidence about people who have been in care shows that they remain vulnerable long after they turn 21.
	A large number of the people affected have disabilities. Severely disabled people are exempt from the single room rate, but disabled people are not, but where do we draw the line between disabled and severely disabled? People make those decisions every day, and they affect people's lives. People who have been in drug, alcohol or substance abuse programmes and ex-offenders are affected, too. Those two groups—people who come out of prison, and people who have been through detoxification programmes—were, under one part of the social security system, given the community care grant, because we recognise that they are in a difficult situation. They need resettling in society and they need help to get over their problems. Under another part of the system, however, we tell them that they will have restricted housing benefit, which means that they can only live in accommodation that is at the allowance rate that has been set, but in most places, that is not available.
	In addition, people who have been in care until the age of 21 are exempt, but most local authorities do not make that information available when someone makes a claim. It is almost by accident that they discover that they are exempt. Similarly, local authorities do not state in the information that they issue that severely disabled people are exempt. If someone forgets to state on their claim form that they receive higher-rate disability living allowance, they are overlooked and they receive the single room rate. Too many of those things are subject to individual judgment. Some authorities attempt to deal with the problem by making discretionary hardship payments, but many authorities do not spend anything on such payments. Some of them publicise the payment, but others do not do so. Once again, there are different attitudes in different parts of the country.

Madeleine Moon: Is it not the case that discretionary hardship payments should not be used to make up permanent housing benefit shortfalls? How can such payments help vulnerable people, who need that extra money to secure accommodation?

Terry Rooney: What I am about to say will probably result in someone being sacked tomorrow, but if a vulnerable person who receives single room rate has mounting arrears in one local authority area, the authority makes a discretionary payment. My hon. Friend is right that such payments should not be ongoing, but the authority makes the payment to clear the arrears. I do not think that that is what discretionary payments were intended for, but some housing benefit officers believe that the rules that they are asked to implement are not right, so they use their imagination, although I accept that that may not be a good thing.
	Time is pressing so, finally, the Government must look at the circumstances that lead people to claim single room rent. As I said, many of them have taken part in drug and alcohol abuse programmes, and many of them have mental illnesses and other problems. We must be honest about the impact of non-dependant deductions. In many parts of the country, the maximum non-dependant deduction is greater than the weekly rent that people pay, which leads to one of two results. Either it encourages fraud—the householder declares that someone has left when, in fact, they are still living at the house—or parents are forced to kick out their children because they cannot afford the impact on their benefit. Non-dependant deductions have grown out of proportion to the problem that they were originally designed to tackle. The issues extend beyond the arguments ably made by my hon. Friend the Member for Edmonton, and I hope that we receive positive signs of a rethink from my hon. Friend the Minister.

Jeremy Hunt: This important set of amendments deals with the serious problem of access to housing for young people under 25. The facts have been comprehensively set before the House by the hon. Members for Bradford, North (Mr. Rooney), for Edmonton (Mr. Love), and for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander).
	At the heart of the problem is the fact that the number of claimants of single room rent fell from 31,600 in 1997 to 11,900 in 2005. Evidence from Shelter, the YMCA and many other organisations suggests that is not because young people have experienced a sudden surge in employment opportunities and earnings. On the contrary, as the hon. Member for Inverness, Nairn, Badenoch and Strathspey said, 35 per cent. of the young people using YMCA accommodation would like to move into their own accommodation but cannot afford to do so. The British Property Federation says that
	"many of our members are reluctant to let to under-25s because of the inadequacy of their Housing Benefit payments to meet the rent required."
	As a result, there is a significant reduction in the supply of affordable accommodation for young people, particularly houses in multiple occupation.
	This is not simply about the level of housing benefit. The increased burden of regulation which, for example, requires landlords to place basins in every single bedroom, has had an impact, too.
	The amendment follows the terms of similar amendments that we debated in Committee. There is an important distinction between principle and practice. Is the problem one of principle, whereby people under the age of 25 should not be required to accept a lower level of housing benefit than other people, or is it one of practice, whereby the level of the single room rate under current regulations, or the shared room rate under the Bill, has not been set at a level that adequately reflects local housing market conditions?
	It is worth looking at what happened in the pilot areas for the local housing allowance. The Department for Work and Pensions report refers to the rent officers, to whom the hon. Member for Bradford, North drew attention. It states that
	"rent officers in some areas"
	of the pilot
	"were facing particular difficulty in gathering evidence in order to set the shared room rate . . . this could mean that as a result the rate is a less reliable reflection of the market, thus compounding claimants' problems".
	There were clear problems in the pilot in setting the right level of the shared room rate, which may be due partly to the highly complicated nature of what the shared room rate has become. The Minister told the Committee that it should be assessed as the rate payable for a room with shared use of either a living room, bathroom, toilet or kitchen.

Danny Alexander: In Committee the hon. Gentleman abstained when we voted on the abolition of the single room rent. Has he changed his position, and is he willing to support the abolition of the single room rent?

Jeremy Hunt: My argument is that the problem with the shared room rate, as it will become, arises from the way it is implemented in practice. The amendment is not the solution. The measure is complicated and rent officers find it difficult to set the rent at an appropriate level. The problem, as the hon. Member for Bradford, North said, is the lack of transparency in the way the rent officer makes his or her calculations as to what the shared room rate should be. Because of that lack of transparency, it is impossible to challenge what may be an arbitrary rate that inadvertently makes it unlikely that young people will be able to afford even shared accommodation.
	Given that the Government are unlikely to accept the amendment, will the Minister give assurances that she is prepared to consider ways to improve the process whereby the shared room rate is calculated? I draw her attention to a particular concern with respect to disabled people. She knows that one of the critical issues for disabled teenagers is the transition into adulthood, which is often poorly managed by local authorities and was correctly identified as an area of focus in the "Life Chances" report.
	The Minister said in Committee that the shared room rate does not apply to people in supported accommodation, but not all young disabled people are in supported accommodation. For many, accommodation in the private sector is a vital first step towards independence and finding a job. Can she give further assurances that the shared room rate will be structured in a way and set at a level that enables young disabled people to make that transition into adulthood and independence?

Anne McGuire: As I said in Committee, I am pleased that we have had the opportunity to discuss issues relating to the single room rate, because I know that it causes great anxiety for many colleagues, particularly many of my right hon. and hon. Friends. I hope that over the next few minutes, I will be able to give some comfort to my colleagues and assure them that they can have confidence in what we are attempting to do with the local housing allowance under the new system.
	For the record, Government amendment No. 12 is a technical amendment which modifies clause 35 to meet the information sharing principles of Her Majesty's Revenue and Customs, once the transfer of the rent officers has taken place in 2009.
	The debate has been wide ranging, and some of the issues raised are of general concern and not specific to the single room rate. The debate has had added value because of that. I emphasise that we are moving to a local housing allowance partly to get rid of the problem highlighted by my hon. Friends the Members for Edmonton (Mr. Love) and for Birmingham, Selly Oak (Lynne Jones)—the anathema of "No DHSS customers" in the private rented sector. What we are doing generally in relation to the local housing allowance, and specifically in relation to young people under the age of 25, is giving people the authority to pay their own rent by having the money given to them as individuals instead of through an intermediary through a housing benefit office, which initially stigmatises them as housing benefit recipients. I hope that that general principle will be accepted.

David Lepper: From my experience of the pathfinder area in Brighton and Hove, I do not believe that the local housing allowance will have the beneficial effect on young people that my hon. Friend believes that it will have when it is rolled out across the whole country. Will she undertake to continue to review the working of the single room rent and the shared room rent as they are rolled out nationally?

Anne McGuire: On Second Reading, my right hon. Friend the Secretary of State stated that we would review the rolling out of the local housing allowance over the next two years to monitor its impact.

Lynne Jones: I do not think that the Minister's proposals will deal with the problem that I identified when I chaired the Birmingham bond scheme—that is, landlords' reluctance to provide shared accommodation for non-student tenants, whether or not they possess the rent. Landlords are unwilling to provide accommodation for people sharing communal areas, whereas they are willing to provide one-bedroom self-contained accommodation.

Anne McGuire: That is an issue for young people irrespective of whether they are on housing benefit or in work and not on housing benefit. The problem is not specific to young people on housing benefit—it is a general attitudinal problem of landlords in relation to single under-25s. With the greatest respect to my hon. Friend, who has great knowledge in this field, a wee bit of a red herring is being drawn across the debate.

Lynne Jones: rose—

Anne McGuire: I appreciate the intensity with which my hon. Friend holds these views, but I should like to move on to deal with some of the specific issues that have been raised.
	The Government's view is that many single people under the age of 25 and not on benefits live in shared accommodation, regardless of questions about the number of accommodation units that are available. If we accepted the amendments, those who are under 25 and on benefits could be trapped in the benefits system, whereas if we continue with the shared room rent we encourage them to start to think about how they can move into work. There is a disadvantage to getting rid of the separation. We went through all the arguments in Committee and I used a specific example of two young people who share accommodation, one on housing benefit and the other not. One moves out and retains maximum housing benefit while the other, who is in work, is no longer entitled to that benefit. It makes a difference.

Nick Raynsford: My hon. Friend makes an interesting point about the possible disincentive to work that accessibility to benefits provides. What is the difference between someone aged 26 and someone who is under 25 in respect of that factor?

Anne McGuire: I hope that my right hon. Friend asked the same question when we considered many other aspects of our support system. Someone aged 25 or over who works at least 30 hours a week is entitled to working tax credit. For those aged 25 and over, contribution-based jobseeker's allowance has a different rate. That also applies to income support. There is, therefore, consistency. I appreciate that it is sometimes difficult for those who are 24 years and 364 days old to understand why they do not qualify when those aged 25 do, but there must be a dividing line. Depending on one's view of where it should be, one can object to when that age differential occurs. The age limit is consistent for a range of benefits and I believe that the clarity of the rule is important.
	In many respects, we have moved away from the principles behind a single room rent to practicalities. The hon. Member for South-West Surrey (Mr. Hunt) made that point. Let me be clear: the changes that we are making to the current housing benefit rules will make a difference to the way in which the single room calculations are made and to the number of accommodation units that will be brought within the remit of the new system.
	In response to the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), I appreciate that the policy was restrictive when it was first introduced. It meant a shared living room, kitchen and toilet. As my hon. Friend the Member for Brighton, Pavilion (David Lepper) highlighted, the accommodation in the pathfinder areas meant exclusive use of a bedroom and shared use of a kitchen, bathroom, toilet and living room. The new system that we are introducing is a dramatic improvement and means the exclusive use of a bedroom—obviously—and sharing one or more out of a kitchen, bathroom, toilet and living room. We have therefore replaced, "and, and, and" with "or, or, or". That is a significant change.
	When the local housing allowance is rolled out nationally, we shall look to define shared room rate accommodation. I believe that that will mean a significant increase in affordable accommodation because we shall use a different calculation system. It will no longer disadvantage young people because we will use the mid-point—the median. The mathematicians among us will recognise that 50 per cent. of the accommodation will always be available to let at or below the local housing allowance rate.

Andrew Love: Although in theory the median is defined as having 50 per cent. below and 50 per cent. above, one has to take into account the likely difference between the rents that are set by the rent officer service and existing market rents. In the past, the difference between the two has caused difficulties and adversely affected young people in particular. Can my hon. Friend reassure the House that the 50 per cent. figure will be borne out in reality?

Anne McGuire: I hope that I can give my hon. Friend that assurance. He is right to say that, under the old system, the calculations used to involve knocking off the highest and lowest amounts. We are now putting in place a system that will involve the calculation of a genuine median across the market. Some of the issues raised by the hon. Member for Inverness, Nairn, Badenoch and Strathspey will be dealt with by that system. I can give my hon. Friend the Member for Edmonton the assurance that 50 per cent. of the accommodation will always be available—

Several hon. Members: rose—

Anne McGuire: I want to move on, because I want to give my hon. Friend the Member for Edmonton the opportunity to consider what I am going to ask him to do in a few minutes.
	I should also like to acknowledge the contribution of my hon. Friend the Member for Bradford, North (Mr. Rooney). We are committed to a review after the implementation of the new local housing allowance, and to assessing the impact that all this will have on young people. We shall also look at the way in which the rent officers operate. Many of them work in close consultation with organisations across their various areas, but we need to improve the way in which the system operates. We need to improve its transparency, consistent with commercial confidentiality. I had a meeting recently with my hon. Friend the Member for Colne Valley (Kali Mountford) and Niall Holland from the Catholic Housing Aid Society, who were very vocal on this issue. Niall Holland has also met the chief executive of the rent service to allay some of his fears and concerns. We want to ensure that the guidance that we produce will support our wider aim of encouraging mixed and sustainable communities, and my right hon. Friend the Secretary of State has clearly stated that there will be a review over the two years.
	I want to give my hon. Friend the Member for Edmonton an opportunity to consider his amendment, but first I want briefly to comment on the sanctions period, as I know that it is a matter of concern to my hon. Friend the Member for Bradford, North. We believe that the setting of a period of five years is reasonable. That will come at the end of a long process and, at any point in that process, someone who is the subject of a sanction can have the sanction lifted by improving their behaviour. We are trying to alleviate the pressures in communities where there are tenants engaging in serious antisocial behaviour, while recognising that we must always give people an exit strategy and an opportunity to come back into the system. We will do that faithfully, and I hope that that assurance will allow my hon. Friend the Member for Edmonton to consider withdrawing his amendment.
	I am sorry that I have had to rush my response to the debate. These are serious issues and, as I said earlier, I know that they cause great concern and anxiety among my colleagues. I ask my hon. Friends in particular to recognise that we are keeping faith with the principle of supporting young people. The whole Bill is about supporting people, and about giving them opportunities that they have not had before. However, on the issues of the age of 25 and of the single room rent, given the changes that we have made, the guidance that we will issue, the support that we will give to local authorities, and the recognition that there are exempt categories, I ask my hon. Friend to withdraw his amendment.

Andrew Love: I thank my hon. Friend for the way in which she has responded to the debate. I am disappointed that there has not been more movement towards a recognition of the impact that the single room rate, and now the shared room rate, will have on young people. Indeed, that impact is already being felt in the pathfinder areas. I take the Minister's reassurances, however, that the median will be a genuine one that reflects real rents, and not just the rents set by the rent officer service. I hope that that is put to the other place when it debates the Bill. On the basis that that will happen, I beg to ask leave to withdraw the amendment.
	 Amendment, by leave, withdrawn.
	 It being Nine o'clock,  Madam Deputy Speaker  proceeded to put forthwith the Questions necessary for the disposal of business to be concluded at that hour, pursuant to Order [this day].

Clause 29
	 — 
	Local housing allowance

Amendment proposed: No. 5, in page 20, line 33, at end insert—
	'( ) The Appropriate Maximum Housing Benefit may not vary according to the age of the claimant.'.— [Danny Alexander.]
	 Question put, That the amendment be made:—
	 The House divided: Ayes 70, Noes 286.

Question accordingly negatived.

Clause 35
	 — 
	Supply of information by rent officers

Amendment made: No. 12, in page 29, line 36, at end insert—
	'( ) A person who receives information by virtue of subsection (1) must not disclose the information to any person unless the disclosure is made—
	(a) for a purpose mentioned in that subsection (including disclosure to another rent officer in connection with any function he has under section 122 of the Housing Act 1996 relating to housing benefit),
	(b) in accordance with any other enactment, or
	(c) in accordance with the order of a court.'.— [Mr. Heppell.]
	 Order for Third Reading read.

Jim Murphy: I beg to move, That the Bill be now read the Third time.
	The Bill implements one of the most ambitious reforms of social security in modern times. It reflects an entirely new approach to the benefits system that is underpinned by the concept that each individual's capability should be recognised—instead of writing people off as incapable. It enshrines the proper balance between rights and responsibilities and it embeds the clear progressive values of opportunity and security— [Interruption.]

Madam Deputy Speaker: Order. Would Members who do not wish to participate on Third Reading please either leave quietly or stay quietly?

Jim Murphy: Thank you, Madam Deputy Speaker.
	I would like to take the opportunity to thank the many individuals and organisations that have played an integral part in the development and passage of the Bill. I particularly thank all the members of the Committee and our two Chairmen who presided over the proceedings, all Members who have contributed to today's debate and, of course, my right hon. Friend the Secretary of State and the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Stirling (Mrs. McGuire). I also wish to put on record my appreciation of all DWP Ministers and of my predecessor, my right hon. Friend the Member for Barking (Margaret Hodge), who played an important role in the early formulation of the Bill.
	I would like to thank my hon. Friends the Members for Ochil and South Perthshire (Gordon Banks) and for Worsley (Barbara Keeley), who also played an important part in our proceedings. In addition, I would like to thank the Bill team and all those in my Department who have worked on the Bill. On behalf of all who served in Committee, I would like to extend our appreciation to the Committee Clerks who assisted us so ably.
	I am hugely encouraged by the positive and constructive atmosphere in which the Bill has been considered throughout our proceedings. When we have agreed, it has been welcome; where we have disagreed, it has always been good natured. That is why such a consensus has developed about the important detail of the Bill.
	The reform of incapacity benefit and its replacement by the employment and support allowance reflects a changing approach to the labour market. It reflects a change in society's attitude, a changed legislative framework and changed attitudes to mental health—particularly to those with mental health difficulties and fluctuating mental health conditions. It reflects a change in society's attitudes to those with learning disabilities and their role in the labour market. Proper support for them is underpinned by the sense that people with learning difficulties can play a constructive, productive and economically valuable part in the labour market.
	The broad consensus that has developed around these reforms reflects the values on which they were built: values of opportunity; the sense of a contract between the state, the citizen and the welfare system; and the fundamental importance of work in tackling poverty and social exclusion and social mobility and fulfilling personal aspirations.

Lyn Brown: Does my hon. Friend share my concern that many people moving away from receiving benefits often find themselves in low-paid employment? Does he agree that the quality of service given to those vulnerable people by Jobcentre Plus in particular is of paramount importance? I have received a number of representations from my constituents on these matters. One deaf person who is also unable to speak was refused a British sign language interpreter for a work-focused interview. How will the quality of service offered to such clients be improved?

Jim Murphy: My hon. Friend has raised that matter before, and I shall be happy to look into the specific problems affecting her constituents, but she is right to say that the effectiveness of the Bill will depend on professional and sensitive interventions to help people to re-enter and remain in the labour market. That applies both to Jobcentre Plus and to organisations in the private and voluntary sectors, and I shall be happy to discuss those matters when I visit her constituency on Thursday.
	The Bill is the latest stage in the development of the welfare state. Extending opportunities has been at the core of the Government's welfare and reform agenda since 1997, and it has involved the creation of Jobcentre Plus, the introduction of the new deal and the extension of the disability discrimination legislation. The Bill creates the employment and support allowance and initiates the national roll-out of local housing allowance, and is the next step along the journey to welfare reform. Contributors to the debate from all parties recognise that we have made real progress in recent times. Pathways is recognised to be the most effective initiative ever of its type when it comes to helping people to get off incapacity benefit and return to work.
	However, one point of collective criticism that I want to make is that we often frame the debate about incapacity benefit, welfare reform, employment and support allowance and all the rest in terms of statistics. They are important, and we have set ourselves the enormous challenge of helping 1 million to leave incapacity benefit over a decade but, as my hon. Friend the Member for West Ham (Lyn Brown) noted, we all know from our constituency casework that people's real life experiences and aspirations underlie every statistic.
	Recently, three people in particular have told me about their hopes and aspirations for the future, and I want to share what they said with the House. One case involves a young female paramedic in Motherwell. She has a brain injury, but more than anything else in her life wants the right to work again. Another involves a young woman from Reading whose mental health fluctuates and who talked with great passion and frustration about how society does not understand the nature of her condition. She too is determined to get a foothold in the labour market again.
	The third case involves a 29-year-old man who is recovering from cancer. He has two young sons: one has a disability, and the other was born with cancer. He told me that until recently he considered himself to be retired from work for the rest of his life. That young man had envisaged that for nearly four decades he would rely on incapacity benefit or employment and support allowance, but the personal intervention made possible by pathways has helped to transform his attitude to work and to his role in society.
	We all know from our constituency work that most people on incapacity benefit want the right to work. When they first claim that benefit, they want—and expect—to return to work. This Bill puts in place the legislative support to enable that aspiration to be fulfilled. Although the state has a duty to help people back to work and to provide support for those who suffer the most significant disadvantage, all who can do so have a duty to take up the support that is offered to them to make progress in preparing for, and gaining, work.
	I can again reassure the House, and the many organisations that have contributed to our debates, that we share the goal of making sure that the most disadvantaged and vulnerable are supported in the best possible way. The treatment of those who are terminally ill has been a concern to many. Let me reassure the House by saying once again that we will continue to look at ways to ensure that they receive the support, through the ESA and welfare reform proposals, to which they are fully entitled.
	Finally, the Bill is a legislative fulfilment of the traditional Labour and trade union demand for the right to work. For too long, too many long-term sick and disabled people have been written off by the welfare system to a life of dependency, entirely reliant on benefit and devoid of experience of the labour market. The Bill puts that wrong right, and I commend it to the House.

David Ruffley: The Bill has noble aims: to get 1 million of our fellow citizens off incapacity benefit. That is achievable, because all the Government's surveys, which we accept, suggest that at least 1 million of the 2.7 million incapacity benefit claimants want to work. That is important in itself, but so, too, is the change of focus in the Bill. The Government are to be congratulated on that. For the first time there is a focus on capability, not just disability. That received cross-party consensus in Committee and in our proceedings today. Long may it continue. There is no "but" coming, so the Minister for Employment and Welfare Reform should not be nervous.
	When the Bill was published, it was described as a flagship Bill—rightly so, for the reasons to which I have just alluded. However, the idea that this is the only major Bill on the subject in this Parliament should not lead us to the conclusion that we have cracked the problem. I know that Ministers would not suggest that for a moment.
	The Bill is a start, but only a start. More needs to be done—not just for those on incapacity benefit, but for lone parents, who may have no incapacity issues, and for older workers. Indeed, a year ago in the Green Paper, the Secretary of State referred to those two groups as parts of the work force who need more assistance. More must also be done for the long-term employed.
	The Bill is only part of the solution. On the Conservative Benches, we know that we have to do more policy thinking. The social justice policy group and its "Breakdown Britain" analysis is part of the work that we shall be doing in future, but Ministers, too, will be doing more. Last month, the Secretary of State announced a new and important review to consider what more could be done in the sphere of welfare reform. The Minister will lead that review.
	Although the Bill is only part of the story, it received serious scrutiny in Committee. In my nine years serving on Committees, this Bill's Committee proceedings have been by far the most collegiate across the party divide. It was good natured and well informed—I shall not refer to the other Bill Committees of which I was a member, as comparisons might be invidious.
	In Committee, the nuts and bolts of the Bill were taken apart and put back together. Ministers answered our queries, as well as those of other Opposition politicians and, on occasion, of Labour Back Benchers, with skill and expertise. Everyone on the Committee had one goal in common: to make sure that we have welfare that works on the ground, not just on paper.
	I would briefly like to thank my team: my hon. Friends the Members for South-West Surrey (Mr. Hunt), for Weston-super-Mare (John Penrose), for Windsor (Adam Afriyie) and last but certainly not least my indefatigable and indispensable hon. Friend the Member for Daventry (Mr. Boswell) whose wisdom, cleverness and civilised values shone through the Committee proceedings—and will continue to do so. He was a huge help to me and my hon. Friend the Member for South-West Surrey in making our maiden appearances on the Front Bench.
	I would also like to talk about the Government's team in all their manifestations and not just the Ministers to whom I have referred. Powerful, wise and intelligent contributions were made, in particular by the hon. Members for North-East Derbyshire (Natascha Engel), for Colne Valley (Kali Mountford), for Plymouth, Devonport (Alison Seabeck) and for Glasgow, North-West (John Robertson). I also wish to thank the Clerks who refereed the proceedings with their usual peerless charm and assurance.
	During the course of the Committee and the proceedings today, clarifications and assurances have been sought and, in large part in many instances, have been given by Ministers to clarify things that were not in the Bill or had been alluded to in the explanatory notes. Much of what has been said in Committee and today will, I know, be very important for the outside groups that have done so much to inform the debate and to brief and to help Opposition Members such as myself. It will probably also mean—and I am sure that the Minister will welcome the observation—more work for us. What he and the Under-Secretary of State for Work and Pensions, the hon. Member for Stirling (Mrs. McGuire), have said on the record will provoke more thoughts and more queries, so perhaps our work begins after the debate today. It will continue.
	I want to say something about the number of regulations that will be issued pursuant to the Bill. The Minister did the Committee a great service by giving it as many of the draft regulations as he could, but that cannot get round the facts that the regulations need a lot more work and that we have not seen some at all. When they are brought back to the House, many outside groups will furiously brief Opposition Members and we will have more work to do. There is a more limited ability for us to have full debates on some of the important regulations, but I know from the assurances that the Minister has given that he will work hard with his hard-working officials to make sure that every "i" is dotted and every "t" crossed.
	I wish to reflect on some of the key issues on which comfort has been given to outside groups. The new PCA is absolutely central to the effective operation of the new regime that the Bill will usher forth. Five dozen dummy runs of the three assessments that are outlined in clauses 8, 9 and 10 have led to a few raised eyebrows outside this place, but the Minister has assured us that they will be looked at carefully to see how the potentially complex interaction between three assessments in one day for one individual in the same place in the same room by the same assessor will operate in practice. He has undertaken to look carefully to ensure that customers will not be disadvantaged in future dummy runs and further work. In particular, we flagged up the problem that a claimant or customer might have to show potentially conflicting things at the same time. The first is his or her level of capability or level of functionality and the second is their level of unwellness. We flagged up the point that that might introduce a conflict of interest. On the face of it, that appears to be a problem, but the Minister has said that he will keep an eagle eye on it.
	The hon. Member for Kingswood (Roger Berry) called for consideration to be given to the desirability of an independent analysis and evaluation of the operation of the new PCA. I hope that the Minister understands that lots of outside groups—not just Opposition politicians—will want to see evidence-based material on how that is working. If that crucially reformed gateway is not got right, the whole system could be thrown into doubt. Customers would not have confidence in the new assessments, which could lead to more appeals. That would not be in the interests of anyone—the Government or the customer.
	We also had an important debate on employers' attitudes. We all understand that the rights and responsibilities agenda requires customers to do what they can to put themselves in a situation that means that they can be work-ready. As we said, 1 million of the 2.7 million people want to be work-ready, with the right assistance. The Bill will help many of them. However, that is the supply side of the equation. The demand side of the equation is that employers have to be more willing to consider recruiting those with an incapacity or disability. That was a point of agreement on both sides of the Committee and the House.
	Anti-stigma campaigns are important. Some 40 per cent. of incapacity claimants have a mental or behavioural condition that leads to their claim being accepted. We know how far employers discriminate against those with mental health conditions and fluctuating conditions. We also know that the issue of talk therapy and better interventions for those with mental health conditions is a top priority—not only for the Opposition and outside groups, but for the Government.
	Some important things were said on both sides of the House about the support group. We had a long and fruitful discussion today. I will not repeat it. Needless to say, those in the support group—the most vulnerable claimants under the new regime—must have the right to volunteer for work-related activities, sure in the knowledge that there will be no sanctions and that resources and every possible assistance will be given to make sure that they get the best possible chance of getting back into the world of work.
	In Committee, we also talked about contracting out. There was widespread agreement that the new contracts must be designed in a way that avoids cherry-picking, so that those who are the most easy to help are not the only people or the first people to be helped by private and voluntary sector contractors. We were also clear that, whether we are talking about incapacity benefit personal advisers at jobcentres or the employees of private and voluntary sector contractors, they must be absolutely up to speed on understanding the needs of the customers and clients. We must consider whether they have enough training in mental health conditions and difficult-to-meet-needs customers, such as those with autism and severe learning disabilities.
	In the course of the Bill's proceedings, we did not have the opportunity to say enough on the earnings disregard and the thorny but hugely important issue of permitted work. How much work can an individual incapacity benefit claimant—soon to be employment and support allowance claimant—do without jeopardising the full value of their benefit package? That is something for another day, I hope, and perhaps for another Bill.
	Finally, there is housing benefit, in part 2 of the Bill. In a series of reassuring contributions, the Under-Secretary was able to give comfort about the sanctions that will be applied in relation to housing benefit for those antisocial individuals who have been evicted by virtue of their antisocial behaviour. They then become subject to HB sanctioning. She showed a real sensitivity to what many outside groups were saying about the sanctions—their comments were reflected by my hon. Friends. Such sanctions should be used exceedingly sparingly, if at all. We must always have any impact on child poverty at the front of our minds. I know that the Under-Secretary does not need lecturing on that. She has been reassuring and I know that her words will be read closely and with care by outside groups and hon. Members.
	There has been much common ground among the political parties on the Bill, but we have not agreed about everything. A lot has been done, but there is a lot more to do. In that spirit, Conservative Members are content to support the Bill on Third Reading.

Terry Rooney: Congratulations are due, especially to the Secretary of State, who walked into a quagmire about 15 months ago when a Green Paper had been several months in germination, but showed no signs of appearing. He injected much needed realism into the process and there was genuine consultation with not only Back Benchers and Opposition spokesmen, but numerous groups outside the House. The subsequent Green Paper and the Bill were far better for that; perhaps the process is a model that other Secretaries of State should follow.
	The Work and Pensions Committee has taken a great interest in the whole process. We followed closely the pathways to work pilots, especially their impact in terms of mental health. As politicians, we are still learning what that really means. The process has meant that we now have a far better system—it is revolutionary—to allow the representative bodies to design the new personal capability assessment. Such a thing might not happen again, but the process has certainly been an interesting experience.
	We need to remember why we are where we are. There is a core of people who have been on incapacity benefit for all sorts of reasons—we do not need to go into the politics of that—for far too long. Sadly, people who are disabled are going to be in poverty. If people have a disabled child in their family, they are going to suffer poverty. Disabled parents with a disabled child will be in even greater poverty. We must address the situation. There was a time when pensioners were almost automatically in poverty, but that is no longer the case. We must get to a point at which that is no longer the case for people with disabilities. A disability is not a reason or excuse for someone to be in poverty.
	Much as the Bill promotes work as an option and is designed to facilitate people moving into work, we must never forget the need for people with disabilities to be retained in work. Quite frankly, the attitude of employers in this country is still a massive problem. It is two years since the strategy unit produced a report on improving the life chances for disabled people, which cited the need for Government Departments, especially the Department of Trade and Industry, to do more work. There has not been anywhere near enough action over the past two years. As I have said many times, discrimination on the grounds of gender or race is almost always malicious, while discrimination on the grounds of disability is almost always due to ignorance. We need an education programme for employers and all parts of the Government need to engage in that; the opportunity to work is the civil right of everyone in society. The Government need to take the action necessary to ensure that those less fortunate than ourselves can have that opportunity.
	We need to find out how the cities strategy will work. The initiative is exciting, but we need to find out how much flexibility we can lend to it. The impact of Leitch gives rise to an enormous agenda.
	The Government should be congratulated on their foresight and courage in introducing the Bill. I do not want to embarrass anyone, but never has the disability lobby had as doughty a champion as the Under-Secretary, my hon. Friend the Member for Stirling (Mrs. McGuire). There might have been someone as good, but there has been no one better. I do not want to deny her any prospects of promotion, but as long as she is in her post, we are in good hands.
	The Select Committee will be keeping a watching eye on the situation. All its members have a great interest in the matter and we want the system to work. There will undoubtedly be teething problems, but given the flexibility in the Bill, I hope they can be dealt with speedily.

Danny Alexander: As has been said, there has been a great deal of cross-party, or all-party, consensus on the principles behind this important Welfare Reform Bill. In particular, there was consensus that we need to encourage greater responsibility from claimants on the one hand, and to offer greater reciprocal support from Government to enable people to get back into work on the other. That is a philosophy that Liberal Democrat Members support very strongly.
	The Bill is the first that I have dealt with as a Front Bencher, and the same is true of the hon. Member for Bury St. Edmunds (Mr. Ruffley), as he said. I am particularly grateful to my hon. Friend the Member for Yeovil (Mr. Laws) for his support. Like the Minister, I would like to thank the Chairs of the Committee, the Clerks, the police and all other people who made our proceedings, and particularly our Committee proceedings, run so smoothly. I also put on record my thanks to the lobby groups. The hon. Member for Bury St. Edmunds mentioned them, too, and I will not list them all. However, the Disability Rights Commission and the Disability Benefits Consortium, which represents a wide range of organisations, both provided enormously valuable briefings and support on part 1. Shelter and Citizens Advice were particularly helpful on part 2, not least on some issues to do with single room rent, which we debated today.
	Sometimes, political consensus gets too cosy. The Committee certainly was not cosy; it was friendly and frank, and both the criticisms and the ministerial responses—and, occasionally, concessions—were perceptive. None the less, too cosy a political consensus is not good for the soul, and things can often seem too cosy from the outside, too, so I should like to offer a few pointers on issues that need to be taken further, beyond proceedings on the Bill. On some of them, there will again probably be cross-party consensus, bizarrely enough.
	First, I return to an issue that I mentioned earlier, although the Minister poured scorn on what I had to say. The issue of funding and support, particularly for the pathways to work programme as it is rolled out, is important. We must make sure that the programme is genuinely available to the 1 million claimants—I suspect that there are actually a lot more than that—who would like to benefit from the additional support. I hope that that subject will be probed further in the other place.
	On a related subject, in respect of the roll-out of pathways to work and the use of the private and voluntary sector, the job has been half done. The Government are taking steps in the right direction, but they still have not fully grasped the opportunities that can be gained by taking advantage of the innovation of the private and voluntary sectors, and their potential to deliver some of the services. I hope that, in due course, the Government will have greater confidence in taking more radical steps in that direction. We Liberal Democrats will certainly develop our own policy on the subject in months to come.
	The Minister has been reassuring about the personal capability assessment today, but there is need for a great deal more reassurance, through further research, evaluation and testing, before everyone can be confident that the new test genuinely meets all the needs that people place on it. The Chairman of the Select Committee, the hon. Member for Bradford, North (Mr. Rooney), rightly referred to the role of employers. It is striking that the Bill has often seemed like a supply-side device to get people ready for work. Too little attention is paid, both in the Bill—although that is perhaps natural, given its context—and generally, to the importance of tackling disability discrimination among employers, and raising disability awareness and confidence among employers. That must be done if we are to avoid a situation in which, because of the successful implementation of pathways to work, hundreds of thousands of former claimants are ready for work, but are unable to take advantage of the opportunities available to them because of other barriers, which might relate not to their disability or impairment but to attitudes in wider society. That is why it is so important to take the social model of disability as a conceptual basis for the Bill.
	On housing benefit, there is unfinished business on the subject of the single room rent and in particular on openness among rent officers, and the way in which the process can be further opened up to public scrutiny. The most significant problem, which taxed everyone in Committee, is the issue of people with mental health problems. There is mixed evidence from the pathways to work pilots of the advantages for people who claim benefit primarily because they have mental health problems. I draw the attention of the House to the work of Lord Layard on the provision of mental health support in the NHS, which is critical to the condition management programme that helps those people to return to work. There is a big gap, however, and a great deal more work must be done if we are to help people with mental health problems back into work.
	One Committee sitting was rather odd, as all parties declared their support for the long-term objective of a single working-age benefit. Thinking on benefit reform must be directed much more along those lines. I hope that those considerations will be taken into account and, with those few caveats, Liberal Democrats are happy to give the Bill a Third Reading.

Roger Berry: Given the limited time, I shall make two brief comments. First, my hon. Friend the Minister is correct that the Bill is about the right to work and the need to tackle poverty. Some 40 per cent. of children with a disabled parent live in poverty, and 48 per cent. of disabled people are out of work. The challenge is enormous. It is easy for Back Benchers who do not deal with the issue daily to forget the scale of the problem and the importance of this policy area. The Bill highlights the Government's enormous progress in dealing with child poverty, but child poverty targets will not be met unless opportunities improve for children in families in which there is at least one disabled person. The size of the task cannot be overestimated.
	Secondly, I very much agree with the hon. Members for Bury St. Edmunds (Mr. Ruffley) and for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) about the importance of the demand side. I am tempted to be blunt, now that we all agree about the need for the measure. The Department for Work and Pensions has worked its socks off to deal with the supply side. We all have criticisms of the Bill, and we can all claim to do better, but it has worked its socks off to produce a package that empowers people into work. I am thrilled by the progress that has been made in recent years, but if we are to create 1 million jobs, private, voluntary, and public sector employers must be prepared to employ 1 million more people.
	I wish that I saw in employers and the Department of Trade and Industry the same commitment to address the problem as I saw in the Department for Work and Pensions. I have engaged in private correspondence with Ministers in the DTI, and I have checked its website and disability equality statement. I have checked what Business Link, the small business sector and the CBI say about such issues and, frankly, it is not a great deal. More significantly, in meeting after meeting with organisations such as the Shaw Trust and bodies that know about the delivery of employment-focused support for disabled people, I hear what ministerial colleagues hear—the employers' contribution must be stepped up. Disabled people have an obligation to take advantage of available opportunities, but there are equally important—arguably more important—obligations on employers to deliver on the demand side. Much more work must be done on the problem, and I look forward to even more joined-up government. I would hate all the good work by the Department for Work and Pensions to be undermined by employers, both collectively and individually, not getting into gear fast enough.

Tim Boswell: The Bill will be memorable to me for three reasons. The first is, as has already been said extensively, the remarkable degree of consensus on the principle, if not on the detail. The second is my own entirely consensual and painless transition from the Front to the Back Benches during its passage. I am grateful to my hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) for his kind remarks about that. The third is the entirely unnoticed but nevertheless confessable sin late in the Committee stage of confusing St. Augustine with Martin Luther, which I hope will draw the indulgence of both confessions.
	We need to remember that the Bill deals with people who are extremely vulnerable. The nature of their relationship with the state is an asymmetric one. The state has abundant coercive power. It can remove benefits from people who have quite small resources. On the other hand, people have to live and find a living. They are not always articulate, they are sometimes unwell and they are sometimes in difficulty. So if we have emphasised the right side of things, and if we have queried, as my hon. Friends and others have done even on Third Reading, some of the applications of the details of the Bill, it has been from the best of motives.
	As we well know, there is a process of welfare reform encompassing the Bill, the regulations that will need to follow, the decisions that flow from them, and the introduction of contractorisation. It also encompasses the principles that continue into other aspects of welfare reform. I did not succeed in getting my baby, the principles clause, debated here, though perhaps it might attract some attention in another place. Nevertheless, it is not only a matter of law.
	Ministers might be frightened of judicial review, but I hope that they will take the principles on which we have agreed and put them in the front of their programme for rolling out the Bill, in the regulations that they draw up, in the benefits handbook and the instructions to decision makers and those who advise them, and finally in the way they handle individual cases.
	In the end, we can agree, and that is a good thing. It is an advance. However, we need to remember that the people about whom we agree do not always have the powers that we have. The credibility of the Bill and what it achieves will stand or fall by whether we treat them decently. It is as simple as that.

Betty Williams: As a long-time supporter of the campaign to end the single room rent—the SRR—restriction on housing benefit for young people, it would be an understatement if I did not express my disappointment that the Government did not grasp the opportunity to abolish it completely.
	In 2000 the Welsh Affairs Committee, of which my hon. Friend the Member for Cardiff, North (Julie Morgan) and I were members, held an inquiry into social exclusion in Wales. In our conclusions we stated:
	"We welcome the Government's recent review of housing benefit set out in the Housing Green Paper published by the DETR and DSS in April 2000. We recommend that the single room rent restriction for young people should be abolished, while measures are taken to ensure that landlords do not exploit the system to offer poor quality housing at inflated rents."
	We took evidence from a great number of people. During our visit we heard repeated complaints about the inadequacy of housing benefit, especially for young people.

Julie Morgan: My hon. Friend quotes from a report published in 2000, when we were both on the Welsh Affairs Committee. Is she aware of the report commissioned by the Welsh Assembly Government, which has recently been prepared by Shelter Cymru? It also draws attention to the dire state of young people under 25 in Wales.

Betty Williams: Indeed. Without going into great detail, we took evidence from many people. In Bangor in my constituency, we were told that SRR was set at £35 a week, whereas the price charged for a one-bedroom flat was between £58 and £75 a week. Such evidence was the basis for our conclusion.
	The Bill offered a unique opportunity to do away with the discriminatory restriction placed on young people under 25 who claim housing benefit. As hon. Members will recall, the policy was introduced by the Conservatives when they were in power.
	 Question put and agreed to.
	 Bill accordingly read the Third time, and passed.

DELEGATED LEGISLATION

Ordered,
	That the Motion in the name of Mr Jack Straw relating to the Electoral Commission shall be treated as if it related to an instrument subject to the provisions of Standing Order No. 118 (Delegated Legislation Committees) in respect of which notice has been given that the instrument be approved. —[ Liz Blackman.]

PETITIONS

Race Relations (Amendment) Act 2000

John Austin: I have a petition from residents of Bexley and neighbouring areas regarding the Race Relations (Amendment) Act 2000, which makes it unlawful for public authorities in carrying out any functions of the authority to do any act which constitutes discrimination.
	The petition states:
	The Humble Petition of residents of Bexley and neighbouring areas sheweth
	That Section 19B of the Race Relations (Amendment) Act 2000 makes it unlawful for public authorities in carrying out any functions of the authority to do any act which constitutes discrimination.
	However, Section 19C exempts courts and employment tribunals:
	'Section 19C (1) Section 19B does not apply to—
	(a) any judicial act (Whether done by a court, tribunal or other person): or
	(b) any act done on the instructions, or on behalf of a person acting in a judicial capacity.'
	The exceptions undermine the intention of the Race Relations (Amendment) Act 2000 and are not in keeping with the spirit of Articles 1, 2, 3, 7, 8 and 10 of the Universal Declaration of Human Rights 1948.
	Wherefore your Petitioners pray that your honourable House will urge the Home Secretary to introduce legislation to bring the judiciary and tribunals within the scope of Section 19B of the Race Relations (Amendment) Act 2000.
	And your Petitioners, as in duty bound will ever pray etc.
	 To lie upon the Table.

Jamil el-Banna

Sarah Teather: This week marks an ignoble anniversary—the fifth anniversary of the opening of Guantanamo Bay. My constituent, Jamil el-Banna, has been held in Guantanamo Bay for four years without trial and without charge. He was picked up in Gambia, where he was on a business trip, and illegally rendered first to Afghanistan and then to Guantanamo Bay. His wife and five British children live in my constituency. Last Easter, working with my local paper, we started a petition for the return of Jamil el-Banna to the UK in order to face a fair trial or to be released. As I hand in this petition, it has an added urgency because his health is failing in Guantanamo Bay owing to poor medical care. Eleven hundred people have signed the petition, with support right across all communities in Brent.
	The petition states:
	The Petition of the supporters of Jamil el-Banna declares that they wish to see him returned to the UK from Guantanamo Bay, Cuba, whereupon he should either face trial or be released.
	The Petitioners therefore request that the House of Commons ask the Secretary of State for Foreign and Commonwealth Affairs to make representations to the Government of the United States of America on behalf of Jamil el-Banna for his return to the UK, and further that the Secretary of State reports to the House on the outcome of those representations.
	And the Petitioners remain, etc.
	 To lie upon the Table.

Bed Tax

Mark Simmonds: I wish to present a petition signed by 2,732 residents on behalf of the Skegness Hoteliers Association, Skegness chamber of commerce and others.
	The petition states:
	The Petitioners declare their concern that the Government may be introducing a new tax known generically as the "bed tax", which could have a negative impact on the UK holiday industry, affecting hoteliers, other businesses in the tourist industry and holidaymakers.
	The Petitioners therefore request that the House of Commons urge the Treasury to reject their proposal for this proposed new tax.
	And the Petitioners remain, etc.
	 To lie upon the Table.

SHELTERED ACCOMMODATION (BEXLEY)

Motion made, and Question proposed, That this House do now adjourn. —[Liz Blackman.]

Derek Conway: Let me start, Mr. Speaker, by thanking you for enabling me to have this brief debate to explain to the House an issue that is of great concern to us in Bexley. I am delighted to see in their places my colleagues who also represent the London borough of Bexley—the hon. Member for Erith and Thamesmead (John Austin) and my hon. Friend the Member for Bexleyheath and Crayford (Mr. Evennett), whom I hope may have an opportunity to catch your eye, Mr. Speaker, during the course of the debate. I am also pleased that the successor to my former seat, my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski), is kindly supporting me tonight. He is a great champion of issues affecting the elderly in his constituency and a far more able Member for that constituency than I was.
	It is appropriate that this debate should follow one that focused so much on the vulnerable because the Adjournment is also partly about them. The problem that I want to put before the House is the proposal by London and Quadrant, the housing association, and its sub-division, London and Quadrant Supported Living, to close several sheltered dwelling developments in the borough of Bexley.
	Six of those developments are in my constituency, including four for closure— Frank Godley court has 41 dwellings; Heron crescent has 44; Mabel Crout court has 26, and Meadows court has 31. We therefore risk losing 142 dwellings, with a proposed upgrade for Bowes close and Wingfield court, which would leave us with only 62 dwellings. I want to present to the House the anxiety that that has caused in the constituency and I am delighted that the Under-Secretary of State for Communities and Local Government, the hon. Member for Sheffield, Heeley (Meg Munn), is in her place because I know her to be a decent and competent Minister and we look forward to her encouraging response.
	The notice that London and Quadrant issued was crass and almost unbelievable. It was not addressed to individual tenants and was simply a circulated notice that made those who received it fear that they were about to lose their homes without any consultation. There was an understandable public outcry and a swift apology followed. However, the elderly residents of the developments were left feeling extraordinarily unhappy, scared and vulnerable. I cannot think of another issue that has made me so angry. I was incandescent at the insensitivity of L and Q towards those elderly residents.
	L and Q tried to blame the cost of supported living but the accounts do not stand much scrutiny. For some reason, L and Q has high central group costs for the supported living developments. Admittedly, only 60 per cent. of the residents pay target rents but that will change. The condition of the properties reflects the acquisition price for L and Q in 1998 of less than £10,000 a unit. It therefore got a good deal for the amount of bricks and land that it acquired. L and Q management claims that upgrading the residences will cost approximately £11 million. For some reason, it shows that as part of a revenue charge. In public and private administration, one would more realistically consider capitalising the sum, which would cost about £700,000 per annum.
	The supporting people grant comes from the Government to the boroughs to help supported living. For our borough, it is ring-fenced at £270,000 per annum. L and Q gets approximately £350,000 per annum and the balance therefore comes from Bexley council tax payers. L and Q now states that it needs £550,000 a year. No one can work out what it thinks it will do with that. It seems a remarkable amount of money for 16 wardens. They are superb people but they are not paid that generously. Where the sum is expected to go remains one of our unsolved mysteries in London.
	I want to place on record my thanks to Bexley council, which took up the cudgels on the matter immediately. It transferred the property in 1998 and the new council leader, Ian Clements, who was already struggling with some difficult budget challenges, and his able chief executive, Nick Johnson, got a grip on the matter. They have gone to town on it and examined L and Q's proposals in great detail. The local councillors, especially those for Frank Godley court, were newly elected—Cheryl Bacon, Ross Downing and Don Massey have been superb. They have encouraged the campaign group and ensured that the issue could not be swept under the carpet. I pay tribute especially to the chairman of the council's working party of officers and members, Councillor John Waters, who brings experience and decency to the challenge. He has already devised some excellent proposals. Bexley council is therefore being positive about the matter. Age Concern Bexley—a superb outfit—has supported the council and all of us in the borough. It has spoken up well for the elderly residents.
	Is the case for closure made? I do not believe that it is. No independent assessment would back closure. Is the financial plan sound? It is certainly not. If that is the way in which L and Q intends to conduct its business, God help the residents whom it supports. Are there alternative providers? L and Q might like to believe that it has Bexley council and its residents up against a wall but alternative providers are available to take on the stock. In another London borough, the property has been returned from a housing association—indeed, from L and Q—to the council for administration and perhaps thence to an alternative provider. There is therefore a way out.
	There remains the question whether sufficient demand exists for sheltered accommodation. L and Q would argue that there is not but I do not believe that the council statistics back that up. However, there is a case for easing the criteria limitations, thus making sheltered accommodation more easily obtainable. People in their 70s are nervous about applying to go into a development, with all the upheaval that that entails, if it is going to close. It is little wonder that people are nervous about making a commitment to move into sheltered accommodation.
	We look forward to hearing the Minister's response. L and Q suggested that the Government no longer supported sheltered accommodation. I have not read or heard that anywhere else and I am sure that the Minister will put the record straight. I hope that the Housing Corporation will, if necessary, support the stock transfer to a new provider. It will be understandably eager not to start a bidding war among its housing associations, but I hope that it will support a transfer if that becomes the only alternative.
	The supporting people grant levels are confusing to those of us who are not accountancy-minded, so I hope that the Minister will have an opportunity to enlighten us on the Government's intentions in that regard. As long as it is personally based, and not borough based, it is a good scheme.
	This has been a cruel and thoughtless exercise. L and Q says that it is shocked by the response to it, but I am not quite sure what it was expecting. Did it really think that people in their 70s and 80s who had been told just before Christmas that they were to be moved out of their homes would be ecstatic about it? I am surprised that L and Q's representatives were shocked. Perhaps they should have been sacked, never mind shocked.
	I should like to pay tribute to the Frank Godley campaigners. They have not taken this lightly; they have fought back very well indeed. They believe that the situation can be changed, and I absolutely agree with them. The residents' demands are not unreasonable. People in that age group do not want a lot of bother or change. They do not want builders running about all over the place if they can avoid it. They are pretty content with their lot, and they are not over-demanding or unreasonable at all.
	I have to confess, wisely or otherwise, that I sometimes find visiting residential and nursing homes a little depressing. There is a often temptation to say that that is not quite how I would want to end my days. There are some very good homes, but there are some mediocre ones as well, as we all know. However, I cannot think of a single visit to a sheltered accommodation development from which I have not come away admiring the balance that is struck between the privacy and independence that people get from having their own flat with its own living room, kitchen, bedroom and bathroom, and the companionship that they can find in the communal lounge when they want it. I am sure that striking that balance helps to slow down the ageing process for many people. They can have their time alone when they want it, but they can also have companionship when they need it.
	I have always found visits to those developments very uplifting, and I believe that our elderly people deserve better than the treatment experienced by those I have talked about tonight. I hope, following this debate and the campaign that has been launched against L and Q, that London and Quadrant Supported Living will think again.

John Austin: I am grateful to the hon. Member for Old Bexley and Sidcup (Derek Conway) and to the Minister for allowing me to participate in the debate. As the hon. Gentleman has said, the homes under threat are in his constituency and in Bexleyheath and Crayford. There is none in mine, because when the housing stock transfer took place, the social housing in my constituency was transferred to a different housing association, Orbit. Nevertheless, social housing represents a borough resource, and this action will result in a reduction in the availability of sheltered housing.
	I accept that there might be occasions on which there is a need to close sheltered housing, perhaps for the refurbishment or redevelopment of poor quality stock or single bedsit accommodation. However, the case has not been made in regard to Mabel Crout court, Frank Godley court or any of the other residences that the hon. Gentleman has mentioned. They offer reasonable accommodation. It could be brought up to a better standard, but not at the kind of cost that London and Quadrant is talking about. L and Q is sitting on a capital asset and believes that it can realise that asset for additional building. That might be of benefit to the borough in terms of additional housing, but it would be achieved at the expense of elderly and vulnerable people who should not be placed in this position.
	I share the opinion of the hon. Gentleman on the crass consultation that took place. I opposed the housing stock transfer, although I do not want to go into that issue now, as that policy is supported by those on my Front Bench as well as by the Conservatives. However, this situation highlights the democratic deficit that exists in the management of social housing, and of sheltered housing in particular. The hon. Gentleman would probably confirm that the council representatives who sit on the board of L and Q were not consulted or informed about this decision, which was taken by a sub-committee. That illustrates the democratic deficit that needs to be addressed when stock is transferred.
	I commend the residents of the various units, including Frank Godley court. They have behaved with the spirit of the person after whom their home was named—Sidney Frank Godley, the first private to be awarded the Victoria cross in the first world war—and they have run a magnificent campaign. This has been a good debate, and it does great credit to Parliament that Members of Parliament of opposing political parties on different sides of the Chamber can unite in their concern for their constituents in this way. I wish that this picture of Parliament could be seen more widely outside. I congratulate the hon. Gentleman not only on securing this debate but on the campaign that he has waged in the borough in support of the local community campaign by the residents of the affected homes.

David Evennett: I am pleased to take part in this debate about the future of sheltered accommodation for the elderly in our borough of Bexley. I congratulate my neighbour and hon. Friend the Member for Old Bexley and Sidcup (Derek Conway) on securing this debate and on his excellent speech, which covered the points so well. I strongly support what he said, and want to add a little to it.
	Like my hon. Friend and the hon. Member for Erith and Thamesmead (John Austin), I am very angry about what has taken place in our borough. The issue, which has aroused such concern and anger across the borough, stems from proposals put forward by London and Quadrant last year, which came like a bolt from the blue. As Members of Parliament, we were not consulted or even advised about the plans; we were excluded completely. London and Quadrant was determined to close a number of sheltered homes.
	The first that I knew of the plans was when residents and their relatives contacted me, having received the letter from London and Quadrant about the closure plans. Naturally, like my colleagues, we took up the matter with London and Quadrant and expressed our concerns and opposition to the approach and policies suggested. We are talking about people's homes and the quality of their lives, and the views of elderly, vulnerable people were not being considered in London and Quadrant's proposals. Matters should not be dealt with in that way, as I am sure that the Minister will agree.
	I visited one of the threatened homes in my constituency, Elwick court in Crayford. I was given a conducted tour of the home, looked at the facilities, spoke at a meeting of residents and listened to their views. I was accompanied by Crayford Councillors Howard Marriner, Geraldine Lucia-Hennis and Melvin Seymour. The home is popular, well-maintained and friendly, and has a great atmosphere. All it needs is a lift to bring it up to the desired standards. That was originally a proposal of London and Quadrant, but it had taken it out of its schedule.
	People were happy in the home, so why should it close? I met a number of elderly residents, including a sprightly 96-year-old who had lived at Elwick court since it opened 26 years ago and who was very worried. Fortunately—as we have heard from my hon. Friend the Member for Old Bexley and Sidcup—under pressure from councillors, the excellent leadership of our new council leader Councillor Ian Clement, the chief executive Nick Johnson and others on the council, local MPs, residents and their families and the local community, London and Quadrant was forced to cease implementing the proposals until after a Bexley council committee, chaired by the long-serving and experienced Councillor John Waters, had deliberated.
	I hope that the facts and human interest issues will come more to the fore, and that London and Quadrant's proposals will be abandoned. London and Quadrant had neither the interests of the residents at heart, nor demand within the borough, as Elwick court was one of the six homes designated for closure, but was not among the six least popular homes. London and Quadrant had to correct the mistake in information that it gave me when it admitted that Elwick court was not among the most unpopular sheltered homes in the borough.
	In the interests of vulnerable and elderly people and their homes, I very much hope that the Minister will ensure that housing associations do not behave in such a way in future.

Meg Munn: Let me congratulate the hon. Member for Old Bexley and Sidcup (Derek Conway) on securing this debate on an important constituency issue, and the hon. Member for Bexleyheath and Crayford (Mr. Evennett) and my hon. Friend the Member for Erith and Thamesmead (John Austin) on supporting his concerns.
	The Government are mindful of the problems and concerns of older people in relation to housing. We recognise the growing challenges and opportunities posed by demographic changes and our ageing population. We know that older age groups will grow more rapidly than the population as a whole, and that there are significant implications for housing-related care and support. The population aged over 80 will grow from 2.3 million in 1998 to 3.2 million by 2021, and long-term projections show a more rapid growth to 4.3 million by 2031 and 6 million by 2050. I would be one of those 6 million if I lived that long.
	Meeting the needs of this group of people is becoming an increasing priority in Government, especially as pressure grows on the small amount of housing stock that is appropriate for older people with support needs—although it should be said that only a minority of older people currently live in sheltered accommodation. The figure of about 3 per cent. of those aged 65 to 69 rises to 19 per cent. of those aged 85 and over. We need to build more homes across the board to meet the increasing needs of our growing ageing population.
	Although London generally has a much younger age profile than the rest of the United Kingdom, it still contains more than 1 million people over the state retirement age. Given the increasing tendency of affluent London owner-occupiers to capitalise on their housing assets and leave London at around retirement age, older people in London are far more likely to be on low incomes, with related poor health, than older people in the rest of the United Kingdom.
	The proportion of people of retirement age in Bexley is relatively high. It was 18 per cent. in 2004 and is projected to rise to 20 per cent. by 2011, along with a 10 per cent. increase in the number of people aged 85 and over. The significance of that group is recognised in the borough's "supporting people" strategy and in its emerging local area agreement, which is currently being negotiated with the Government office for London.
	Along with the London boroughs of Bromley, Greenwich, Lewisham and Southwark, Bexley is a member of the South East London Housing Partnership. The partnership has its own housing strategy, which is the basis for the delivery of new affordable housing through Housing Corporation investment and investment in private-sector housing through the London Housing Board in south-east London. The partnership is assessing and reviewing the needs of older people in a sub-regional context, including demand for sheltered accommodation, domiciliary support and the role of the private sector. The findings will be used to develop a sub-regional action plan for the provision of housing and support for older people.
	Sheltered housing continues to be popular and an excellent range of accommodation is available, but in some areas there is over-supply and under-demand. Some sheltered housing stock is outmoded, and may need remodelling or change of use to be fit for current or future needs and expectations. Some, indeed, may need to be demolished. As the hon. Member for Old Bexley and Sidcup pointed out, care homes are often perceived as dated and not what most of us would choose for our later years. They tend to be associated with dependency rather than independence.
	As for the future and value of sheltered housing, the Government recognise the valuable contribution that it can and is likely to continue to make in offering safe and comfortable accommodation—with its own front door, as the hon. Gentleman said—for older people. Where there is a realistic need and a genuine demand for continued provision of sheltered accommodation, some existing schemes will need to be remodelled or converted to meet more modern and acceptable standards of accommodation and fulfil the needs and aspirations of today's and future generations of older people.
	I agree with other Members that when changes are envisaged—whether to meet the needs of people in the area or because of concern about the condition of accommodation—it is enormously important for any consultation on proposals affecting the homes of elderly and vulnerable people in particular to be undertaken in a sensitive and proper manner. We need to get the balance right, so that more older people have the opportunity and means to stay in their own homes, where they have been for many years—with the right support and adaptations where needed—as long as they want, if that is a realistic option. We also need to look at other options, such as what I understand is now beginning to be called floating support. I worked for many years in social services, and we probably called it something else, but such names and terms change. We have measures such as telecare, community alarm systems, adaptations and disability facility grants. They are all important measures that can support people to remain living comfortably and happily in their family home if they want to do so.
	The supporting people programme is enormously important. It provides help to more than 1 million people nationally per year through a £1.7 billion programme. Among other activities, it enables vulnerable people to move into, or stay independent in, their own home in their own communities. Supporting people funding of £350 million has been allocated for London administrative authorities for 2007-08, of which Bexley will receive £3 million.
	There are some 1,350 social sector sheltered accommodation units in the London borough of Bexley, which are run by a mixture of local housing associations, with just under a third owned by London and Quadrant Group, which is the largest provider. I understand that, like many other local authorities, Bexley has been undertaking a review of housing and support for older people. The review includes an assessment of the supply and type of, and demand for, sheltered housing, and the findings are due to be reported in the spring.
	As the hon. Member for Bexleyheath and Crayford mentioned, Bexley council set up a member working group specifically to review London and Quadrant housing association's plans for its sheltered housing in the borough. The review was launched after residents of the schemes and their relatives contacted local councillors to express their concerns about proposals to close some schemes in the borough and remodel others. Following discussions with council officers, London and Quadrant agreed not to take any decisions until after the council had carried out a thorough examination of the issues.
	I understand that members of the group have now visited each of the sheltered schemes to hear the views of residents and to see the physical condition of the buildings, and that it has been agreed that independent, specialist consultants should go into each scheme to find out in confidence what residents want for the future, so that their views can be fully taken into account in any decisions that are eventually made. Every resident of sheltered accommodation will be offered the chance to contribute and will be able to have relatives or friends with them when the interviews are conducted. The consultation and research exercise will be carried out over the coming months. That means that no decisions will be taken about the future of the schemes until the spring.
	The council is also using its community strategy and emerging local area agreement—LAA—to address the needs of older people. Proposals include increasing the proportion of older people supported to live in their own home and assisting vulnerable people, including the elderly, to access good-quality and affordable housing. I am sure that Bexley's aspirations in respect of the housing needs of its older people are not unique and I encourage the council to consider the way forward in the context of national and regional policy developments, which are raising the profile of the issues facing this important section of the population. The council's ongoing review of housing and support for older people appears to be a valuable first step in determining the way ahead for Bexley.
	One of the key issues that Members will be concerned about is the sustainability of whatever options Bexley and its partners choose to pursue, and the scrutiny arrangements that are put in place. The future of housing provision for older people is a key strategic issue, and one which I would expect the local strategic partnership to address in taking forward the local area agreement for Bexley, which we expect to agree in the next month or so. The issue of alternative providers was raised; I cannot comment on those issues today, but they obviously can be discussed in the wider context. It will be important for the Government office for London to work closely with Bexley in reviewing and, if necessary, refreshing the agreement to ensure that the needs of this section of the community are properly addressed. The Government office is already in dialogue with the council about how it intends to develop its local area agreement in the light of the recently published local government White Paper in order to deliver improved levels of accountability and services that reflect those local aspirations. I expect that dialogue to continue and to address the sort of issues that hon. Members have raised on the Floor of the House tonight.
	I conclude by congratulating the hon. Member for Old Bexley and Sidcup and other hon. Gentlemen on raising these issues. It is right for all of us, as constituency MPs, to put forward issues that have affected and will affect the people whom we represent. As my hon. Friend the Member for Erith and Thamesmead said, that has been reflected well in the House tonight, so I congratulate all those involved in the debate.
	 Question put and agreed to.
	 Adjourned accordingly at half-past Ten o'clock.